Clinical Neurology
Back Clinical Neurology Tsigiro. El Paso, TX. Chiropractor, Dr. Alexander Jimenez anokurukura clinical neurology . Dr. Jimenez anopa ruzivo rwakanyanya rwekutsvakurudza kwakagadzikana kwezvinonyanya kuoma uye zvinowanzokanganiswa neurological kusanganisira misoro, chizivo, kushaya simba, kupera, uye ataxia. Izvo zvinotarisa zvichava pane pathophysiology, zviratidzo, uye kutarisa marwadzo maererano nekusuruvara nemamwe maitiro emagetsi, ane kodzero yekusiyanisa zvakakomba kubva kubenin pain pain syndromes.
Kutarisisa kwedu kwekiriniki uye zvinangwa zvedu ndezvekubatsira muviri wako kuzvirapa wega nenzira inokurumidza uye inoshanda. Dzimwe nguva, ingaratidzika senzira refu; zvisinei, nekuzvipira kwedu kwauri, chokwadi rwendo rwunonakidza. Kuzvipira kwauri muhutano ndiko, kusamborasikirwa nekubatana kwedu kwakadzama kune mumwe nemumwe wevarwere vedu murwendo urwu.
Kana muviri wako uine hutano hwechokwadi, unosvika padanho rako rekusimba rakakwana. Tinoda kukubatsira kuti urarame hupenyu hutsva uye huri nani. Kwemakumi emakore ekupedzisira e2 tichitsvaga uye nzira dzekuyedza nezviuru zvevarwere takadzidza zvinoshanda zvinobudirira pakuderedza marwadzo tichiwedzera simba revanhu. Kuti uwane mhinduro kumibvunzo ipi yaungave unayo ndapota fonera Dr. Jimenez pa915-850-0900.
by Dr Alex Jimenez Clinical Neurology
El Paso, TX. Chiropractor, Dr. Alexander Jimenez anotarisa kugunun'una, kushaya dutu uye kurapa.Kugumburwa zvinotsanangurwa se, kushambadzira kusina kujairika kana mufambiro kubva kumabasa asingagoneki emagetsi muuropi. Kugumburwa chiratidzo chekufa pfuti asi havazi vese vane pfari vane pfari. Sezvo paine boka rehukama hwakanangana nehunhu hunoonekwa nekugwinha kunoitikapfari iri boka rematambudziko anowirirana uye anozivikanwa nekugumburwa kunowanzoitika. Kune marudzi akasiyana-siyana ekuputika uye kugumburwa. Kune mishonga yekurapa iyo inorayirwa kuti itadze kudzivirira, uye chirwere hachiwanzodikanwa kana mishonga isingabatsiri.
Kufenda & pfari
Kukanganisika kunoitika kana pane kuparara kwemavara uye kushandiswa kwechikwata chemapoka e-neuron, kazhinji mukupindura kune chinokonzera sekusagadzikana kwemagetsi
chero ubongo inogona kubatwa kana mamiriro acho akanaka
Chirwere chekurwadziwa kana kugunun'una, ndiko kuwedzera kwehutachiona hwehutachiona hunoitika mukati mevanhu ubongo
Seizure Categories
General / Global inotanga kubatwa
Kubata motokari yemagetsi (Grand mal)
Kusabatwa kwekutora (Petite mal)
Focal allt seizures
Kunyoresa kusarura zvishoma
Motor cortex (Jacksonian)
Sensory cortex
Somatosensory
Auditory-vestibular
zvekuona nemeso
Olfactory-gustatory (uncinate)
Kushanda kwechikamu chakakwana (libmbic)
Kuenderera mberi / kuenderera mberi kwekukurira
Generalized (status epilepticus)
Focal (epilepticus partialis continua)
Generalized Motor Seizure
Kurapa kwemagetsi kweeuroni muhutachiona hwose hwekthete panguva imwe chete
Trigger inofungidzirwa kuva kunze kwe cerebral cortex, yakadai se thalamus kana brainstem
Zvikamu zvinotanga nekurasika kwekuziva zvakatevedzerwa ne tonic contraction (extension)
Kufema kunomiswa, uye vhudzi rinodzingwa kupfuura glottis yakavharwa ( cry )
Yakawedzera kuwedzerwa kweropa, vadzidzi vakaputika
Kurwisana kwepakati nepanozorodza (clonic basa)
Kazhinji inopedza maminetsi mashomanana, asi kune vamwe varwere vanogona kupedza maawa kana mazuva (status epilepticus)
Kazhinji inotanga muhuduku
Tonic Clonic Seizure
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
My Tonic Clonic / Grand Mal Seizure
VIDEO
Seizure Inotyisa
Ionic kusagadzikana (Na, K, Ca, Mg, BUN, pH)
Kunyengedza kuzvidzora muropa (alcohol, barbiturates, benzodiazepines)
Hypoglycemia
Hypoxia
Hyperthermia (kunyanya varwere vari pasi pemakore anopfuura 4)
Toxin inosangana
Genetic kusanzwisisika kusanzwisisika kweeuroni (kazhinji)
EEG Yakukuru Makuhwa
Tonic phase Clonic phase Postictal phase
Swenson, R. Epilepsy. 2010
Kutadza (Petit Mal) Kugumburwa
Kazhinji kazhinji inowanikwa kuvana
Kubva mumusoro we brain brain
Kazhinji zvinoratidzika sekurasikirwa nechitima chepfungwa kana kutarisa munzvimbo
Idzi vana vanogona kuramba vachikudziridza kukanganisa kwakapera muupenyu
Kuregererwa kwepachivande kunogona kuitika sezvo neuroni yakakura
Kusina Kuchengetedzwa Kwakaitwa paKamera
VIDEO
EEG Ya Petit Mal Seizure
3 spike-mawimbi / wechipiri Inogona kupiwa ne hyperventilation Spike = kufarira Wave = inhibition
Swenson, R. Epilepsy. 2010
Simple Focal / Partial Seizures
Unogona kunge uri kana usina wechipiri
Murwere anowanzochengetedza pfungwa
Tanga munharaunda inonyanya kushanda nzvimbo ye cortex
Zviratidzo zvakasiyana uye zvikamu zvichienderana nepo uri muuropi basa rekuchirapa rinobva
Nharaunda dzinonyanya kugadzirwa dzinowanzoita chiitiko chakanaka (kuona magetsi, kunhuhwira chimwe chinhu, nezvimwe, kunze kwekushaikwa kwekunzwa)
Nzvimbo dzemotokari dzinogona kubudisa zviratidzo zvakanaka kana zvisina kunaka
Basa remunzvimbo yekubatanidza rinogona kuderedzwa panguva yechikamu chekuita
Kana iyo yekutanga motokari inobatanidzwa = "Todd paralysis "
Partial (Focal Seizure) 12 Yr Old Boy
VIDEO
Kuchengetedza Kusarura MuInjini Cortex
Inogona kutanga sekukanda kwomuviri mumwechete, pamubatanidzwa wechipatara kune basa rekudzivirira, asi rinogona kupararira kuburikidza nemuviri muitiro wevanhu (Jacksonian seizure / march)
www.maxplanckflorida.org/fitzpatricklab/homunculus/science/
Kusarura Kunosarura MuSomatosensory Cortex
Inobereka paresthesia pamativi akasiyana-siyana kumabasa epileptiform uye inogonawo kupararira mumhando yeumambo (maraka) yakafanana neya motokari
en.wikipedia.org/wiki/Cortical_homunculus
Kusarura Kusarura MuNyaya yeApriitory - Vestibular Area
Posterior temporal region involvement
Inogona kubudisa tinnitus uye / kana vertigo
Audiometry ichave yakajairika
Kusarura Kusarura MuItual Cortex
Inogona kubudisa mazano munzvimbo inotaridzika
Visual cortex (calcarine cortex) yakabudisa kupenya, mavara, uye / kana zig-zags chiedza
Kubatana kwekuona mahara cortex inobatanidza kukwana kwakakwana kwakadai sekanyorera mabhaloni, nyeredzi, uye mapurogoni
Kusarura Chikamu MuOffactory - Gustatory Cortex
Inogona kubudisa mafungiro emagetsi
Zvichida nzvimbo yekupararira kune mamwe maitiro akawanda
Zvikamu Zvikamu Zvikamu Zvokuda
Inosanganisira sangano rekubatana kwepamberi, nguva dzemazuva kana parietal lobes
Kufanana nekudzivirira kusarura zvishoma asi kunogona kuve nokuwedzerwa kwakawanda / kuderedza pfungwa
Limbic Cortex (hippocampus, parahippocampal temporal cortex, retro-splenial-cingulate-subcallosal cortex, orbito- frontal cortex, uye insula) ndiyo inonyanya kukuvara
Nokudaro iyi ndiyo inowanzove yakawanda yechipfupa
Zvinogona kubudisa zviratidzo zvekuona uye zvinokonzera (zvinowanzoitika), zvinoshamisa uye zvisingafadzi zvinonhuwira uye zvinonakidza, zvinoshamisa zvisingaiti zvemuviri, kutya, kuzvidya mwoyo, kazhinji kushatirwa, uye kuda zvepabonde zvakanyanya, visceral uye zviitiko zvekuita zvakadai sekunyorova, kutsva, lip smacking, salivation, kudarika mvere, kuchema, penile erection, kudya, kana kumhanya
Zvikamu zveZvikanana zvakasiyana-siyana MuChimwe Checheche
VIDEO
Kuenderera mberi / Kuramba Kuchinge
2 Mitauro
Generalized (status epilepticus)
Focal (epilepticus partialis continua)
Kuramba kunopfuurira kana kuti kunowanzoitika pane imwe nguva ye30 isina kudzokera kune yakanaka pane nguva
Basa rekukurumidza kwenguva refu kana kuti kukanganisa kwakawanda kunoitika pedyo pamwe chete pasina kuzorora zvakakwana pakati
Kazhinji kazhinji kuonekwa semugumisiro wekurwadziwa kwemaanti anticonvulsive nekuda kwekuderedza hyperexcitability
Kuwedzererwa mupfungwa, fever, kana mamwe maitiro e hypermetabolic, hypoglycemia, hypocalcemia, hypomagnesemia, hypoxemia, hutu hwehutu (semuenzaniso, tetanus, uremia, unremia, zvinokonzera kushamwaridzana zvakadai samamphetamine, aminophyline, lidocaine, penicillin) uye kuregererwa kunogona kunotangirawo kukunda
Mamiriro Epilepticus
Kuenderera mberi kwekukuvara kwekukuvara kwechirwere ndikokukurumidzira kwechirwere nokuti zvinogona kuita kuti uropi hukuvadzwa kana kufa kana kukanganisa kwenguva refu kusina kubviswa
Kuwedzera kwekushisa pamusana pemabasa ekusimudzira musimba, hypoxia nekuda kwekushaya kwakakwana kwemavhenekeri uye yakaoma lactic acidosis inogona kukanganisa neurons
Rufu runogona kukonzerwa nokushamiswa uye kudengenyeka kwema cardiopulmonary
Epilepsia Partialis Continua
Kunotora hupenyu hunotyisidzira kupfuura chiremera chekufa, asi kubata basa kunofanira kupedzwa sezvo zvichigona kufambira mberi kune fomu yakagadziriswa kana yakabvumirwa kuramba ichienderera mberi kwenguva yakareba
Ive nemugumisiro weweoplasm, ischemia-infarction, inokonzera kutyisa kana hyperglycemia
Kurapa Kwekugumburwa
Kana kukanganisa kunokonzerwa nemamiriro ezvinhu akadai, soutachiona, kukanganiswa kwehuwandu hwemvura uye electrolyte kuenzanisa, zvinodhaka uye zvisingagumi zvekushaya simba, kana kusakundikana kwechirwere, kurapwa kwechikonzero chiripo kunofanira kusimbisa basa rekukunda
Mazhinji antiepileptic mishonga inobata akawanda marudzi ekubatwa - asina kukwana zvakadaro
Zvimwe zvinowanzobudirira (phenytoin, carbamazepine, valproic acid uye phenobarbital)
Iko kune avo vane zvigaro zvishoma (gabapentin, lamotrigine uye topiramate)
Imwe mishonga inobata chete chirwere chimwechete (sezvinonzi ethosuximide yekutadza kusagadzikana)
Sources
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
by Dr Alex Jimenez Children , Clinical Neurology , El Paso Chiropractic News
El Paso, TX. Chiropractor, Dr. Alexander Jimenez anotarisa zvinetso zvekukura kwevana, pamwechete nezviratidzo zvavo, zvinokonzera uye kurapa.
Cerebral Palsy
4 Mitauro
Spastic Cerebral Palsy
~ 80% yePC maitiro
Dyskinetic Cerebral Palsy (inosanganisira athetoid, choreoathetoid, uye dystonic cerebral palsies)
Ataxic Cerebral Palsy
Mixed Cerebral Palsy
Autism Spectrum Disorder
Autistic Disorder
Asperger's Dambudziko
Kupararira Kwekuvandudza Dambudziko Hazvina Kunze Zvakatsanangurwa (PDD-NOS)
Childhood Disintegrative Disorder (CDD)
Autism Spectrum Disorder Red Flags
Kukurukurirana Nevanhu
Kushandiswa kusinganzwisisiki kwemaitiro
Kutaura kunonoka kana kusava nehanya
Odd inzwi kana inzwi risingawanzwi rezwi
Dambudziko rekutarisa maziso, zviratidzo nemashoko panguva imwe chete
Kunyatsotevedzera vamwe
Haasashandisi mazwi avakashandisa
Inoshandisa ruoko rwemumwe munhu sechishandiso
Social Interaction
Zvakaoma kutarisa maziso
Kutadza kwekutaura kunofadza
Kushaya kwekuita kwezita
Usaedze kukuratidza zvinhu zvavanofarira
Kudzokororazve Maitiro uye Akabvumidzwa Kufarira
Nzira isina kufanira yekufambisa maoko avo, minwe kana muviri
Inovandudza mitambo, yakadai sekunamatira zvinhu kana kudzokorora zvinhu
Inoisa pfungwa pane zvinhu zvisingawanzoitiki
Kufarira zvakanyanya pane chimwe chinhu kana basa iro rinopesana nekubatana kwevanhu
Zvisingawanzwi zvido zvekunaka
Pasi kana kupfuura kupindura kwe sensory input
ASD Kuziva Zviratidzo (DSM-5)
Kukanganisa kusingaperi mune hutano hwemagariro evanhu uye kushamwaridzana kwemagariro kune dzimwe nheyo dzakawanda, sezvinoratidzirwa neiyo inotevera, ikozvino kana neyakaitika (mienzaniso inofananidzira, kwete yakakwana; ona mashoko):
Kukundikana mune zvekugara-manzwiro ekudzokorora, zvichienzanisa, somuenzaniso, kubva pakusagadzikana kwevanhu uye kusagadzikana kwekukurukurirana kwekare-uye-kunze; kuti kuderedze kugoverana, kufarira, kana kuchinja; kukundikana kutanga kana kuti kupindura kunobatana kwevanhu.
Kukanganisa mumitauro isinganzwisisiki inoshandiswa pakubatana kwevanhu, zvichienzanisa, semuenzaniso, kubva pamashoko asingatauriki akabatanidzwa uye asingatauri kutaura; kushaya kukanganisa muziso rekuona uye mutauro wemuviri kana kukanganisa mukunzwisisa uye kushandiswa kwemaitiro; kusvika pakushaikwa kwese kwemaonero uye kusataura kwemashoko.
Kukundikana mukukudziridza, kuchengetedza, uye kunzwisisa hukama, kubva, semuenzaniso, kubva kune matambudziko kugadzirisa maitiro kuti ataridzane nemamiriro ezvinhu ehutano akasiyana-siyana; kune matambudziko mukugovana nekufungidzira kwekutamba kana mukuita shamwari; kusava nehanya kune vezera.
ASD Kuziva Mazano
Zvinongororwa, kudzokorora maitiro emafambiro, zvido, kana mabasa, sezvinoratidzirwa nevanenge zvikamu zviviri zvezvinotevera, ikozvino kana nezvenhoroondo (mienzaniso inofananidzira, kwete yakakwana; ona mashoko):
Inofanirwa kana kudzokorora mafambiro emagetsi, kushandiswa kwezvinhu, kana kutaura (semuenzaniso, zvigadziriswa zvemotokari zvisiri nyore, kuvhara zvidhori kana zvinhu zvinoputika, echolalia, mazwi ediodyyncratic).
Kuomerera pahumwechete, kusagadzikana kusinganzwisisiki kumagariro, kana kuronga maitiro emashoko kana maitiro asingakoshi (semuenzaniso, zvakanyanya pakutambudzika pane zvishoma kuchinja, matambudziko nekutendeuka, maitiro akaoma, mafungiro, kuratidzira kutora nzira imwechete kana kudya zvokudya zvakafanana zuva rimwe nerimwe).
Zvinonyatsorambidzwa, zvakagadziriswa zvisingawanzoregi mukutarisa kana kutarisa (semuenzaniso, kusungirirwa kwakasimba kana kufungisisa nezvinhu zvisina kujairika, zvakanyanya kudarika kutsungirira zvinodiwa).
Hyper - kana Hyporeactivity kune chinangwa chinowanikwa kana chinowanzoshamwaridzana munharaunda yezvakatipoteredza (semuenzaniso inoratidza kusava nehanya nekurwadziwa / kutonhora, kutadza kusangana nemanzwi chaiwo kana mavara, kuwedzerwa kunhuhwirira kana kugunzva zvinhu, kuonekwa kunofanirwa nemagetsi kana kufamba).
ASD Kuziva Mazano
Zviratidzo zvinofanira kunge zviripo munguva yekutanga kukura (asi zvingave zvisingazove zvichinyatsooneka kusvikira zvigaro zvevanhu zvinopfuura kudarika zvishoma, kana kuti zvingave zvakasvibiswa nemaitiro akadzidziswa muhupenyu huri mberi).
Zviratidzo zvinokonzera kukanganisa kunokosha kwehutano, zvebasa, kana zvimwe zvezvinhu zvinokosha zvekushanda kwezvino.
Izvi zvinopesana hazvo zviri nani zvinotsanangurwa nekuremara kwepfungwa (chirwere chokuvandudza pfungwa) kana kuti kukurumidza kukura kwenyika. Kuremara kwepfungwa uye kuvhiringidzika kwevistism zvinowanzoitika; kuita sarudzo dzisingabatsiri dzevirist disorder disorder uye kuremara kwepfungwa, hutano hwekugara kwevanhu hunofanira kunge huri pasi pezvinotarisirwa kune huwandu hwekuvandudza.
ASD Kuziva Zviratidzo (ICD- 10)
A. Kubudirira kusina kunaka kana kusina kunaka kunoratidzika kusati kwapera makore e3 mune imwe yenzvimbo dzinotevera:
Mutauro unogamuchira kana unyanzvi sezvinoshandiswa mukukurukurirana kwevanhu;
Kubudirira kwekushamwaridzana kwevanhu kana kushamwaridzana kwevanhu;
Inoshanda kana inofanirwa kutamba.
B. Zvikamu zvinenge zvitanhatu kubva ku (1), (2) uye (3) inofanira kuvapo, uye inenge mbiri kubva (1) uye imwechete kubva kune imwe neimwe (2) uye (3)
1. Kukanganisa kwakakodzera mune zvekugarisana kwevanhu kunoratidzika mune zvikamu zviviri pane zvinotevera:
a. kukundikana kwakakwana kushandisa meso neziso, kutarisa chiso, kumira muviri, uye zviratidzo zvekutonga kushamwaridzana;
b. kukundikana kukura (nenzira yakakodzera nguva yepfungwa, uye pasinei nemikana yakawandisa) ukama hwevezera hunobatanidza kugoverana kwezvido, mabasa uye manzwiro;
c. kushomeka kwemagariro-emanzwiro ekudzokedzana sekuratidzwa neakaremara kana kutsauka mhinduro kune vamwe vanhu manzwiro; kana kushomeka kwekuchinja kwemaitiro zvichienderana
d. kushayikwa kwekuzvitsvaga kutsvaga kugovana kufara, zvido, kana kubudirira nevamwe vanhu (semuenzaniso kusakwanisa kuratidza, kuunza, kana kureva kune vamwe vanhu zvinhu zvinofadza kune mumwe munhu).
2. Kuita zvinhu zvisina kukodzera mukukurukurirana sezvinooneka mune imwe yenzvimbo dzinotevera:
a. kunonoka kana kushaikwa kwese, kusimbiswa kwemutauro wakataurirwa usingatauri nemuedzo wokubhadhara kuburikidza nekushandiswa kwechimiro kana kumira seimwe nzira yekukurukurirana (kazhinji inotangira nekushayikwa kwekutaurirana);
b. kushaya kukwana kutanga kana kuchengetedza kushamwaridzana kwekukurukurirana (pane chero ruzivo rweunyanzvi hwemutauro huripo), umo pane kugadzikana kwekuteerera kune zvinyorwa zvemumwe munhu;
c. kushandiswa uye kudzokorora kushandiswa kwemutauro kana kushandiswa kwemashoko emashoko kana mazwi;
d. kusava nemhando yakasiyana-siyana yekuita-kutenda kutamba kana (kana vaduku) social social imitative play
3. Zvinoregererwa, zvinodzokororazve, uye zvisingatauriki maitiro emafambiro, zvido, uye mabasa zvinoratidzwa mune imwe yeiyi inotevera:
a. Kunyanya kufungisisa nezvimwe kana zvakawanda zvakatsanangurwa uye zvisingabvumirwi mapepa ezvinyorwa zvisinganzwisisike muhutano kana kuisa pfungwa; kana chimwe kana zvimwe zvinofadza zvisinganzwisisiki mumatauriro avo uye zvakasvibiswa asi zvisati zviri mune zvavanenge vachitaura kana kuisa pfungwa;
b. Zvinoratidzika kuti zvinomanikidzika kuomerera kune zvakananga, zvisingabatsiri tsika kana tsika;
c. Inofanirwa uye inodzokorora mitambo inosanganisira ruoko kana kuti kuisa kumunwe kana kushandura kana kukanganisa kufamba kwomuviri wose;
d. Kunyanya kunetseka nezvimwe zvikamu zvezvinhu zvisingasviki zvezvinhu zvekutamba (zvakadai seavo, kunzwa kwavo kwepamusoro, kana ruzha kana kutinhira ivo
C. Chiratidzo chemakiriniki hachikonzerwe kune mamwe marudzi ezvirwere zvinokura zvekupararira; yakanangana nekusimudzira kusagadzikana kwemutauro unogamuchira (F80.2) nematambudziko echipiri ezvemagariro-emanzwiro, chirwere chinogadzikana chekubatanidza (F94.1) kana disinhibited chinamato chekubatanidza (F94.2); kudzoreredza kwepfungwa (F70-F72) pamwe nehumwe hukama hwepfungwa kana hunhu; schizophrenia (F20.-) yekusanzwisisika kutanga kwekutanga; uye Rett s Syndrome (F84.12).
Asperger's Syndrome Kuongorora Criteria (ICD-10)
A. Kukanganisa kwakakodzera mumubatanidzwa wevanhu, sezvinoratidzirwa nevanenge zviviri zvezvinotevera:
kukanganisika kwepachiratidzo mukushandiswa kwezviito zvakasiyana-siyana zvisingabatsiri zvakadai sekuona-meso-kwiso, kutarisa kwechiso, kumira kwomuviri, uye zviratidzo zvekutonga kushamwaridzana kwevanhu.
kukundikana kukudziridza hukama hwevezera hunobatsira pakukura.
kushayikwa kwekuzvitsvaga kugovana kufara, zvido, kana kubudirira nevamwe vanhu (semuenzaniso nekushaya kuratidza, kuunza, kana kuratidza zvinhu zvinofadza kune vamwe vanhu).
kusagadzikana kwevanhu kana zvekufunga.
B. Kunongodzokorora kudzokorora uye kusagadzikana maitiro emafambiro, zvido, uye mabasa, sekuratidzwa nezvimwechete zvinotevera:
kunyanya kufungisisa neimwe kana kupfuura zvakasarudzwa uye zvisingabvumirwi maitiro ezvakafarirwa izvo zvisingawanzo kana muhutano kana kuisa pfungwa.
zviri pachena kusagadzikana kunamatira kune zvakananga, zvisingabatsiri tsika kana tsika.
kutaridzika uye kudzokorora mitambo yemagetsi (semuenzaniso, ruoko kana kuti kuisa kumunwe kana kushandura, kana kuti zvakaoma kufamba muviri wose).
kuramba uchifungisisa nezvikamu zvezvinhu.C. Kuvhiringidzika kunokonzera kliniki kusimba kwakanyanya mumagariro evanhu, kushanda, kana zvimwe zviitiko zvinokosha zvekushanda
D. Hapana hutachiona hunonyanya kukoshesa mutauro (semuenzaniso, mazwi asina kushandiswa anoshandiswa nezera remakore 2, mabhii ekutaura anoshandiswa nezera remakore 3).
E. Hapana kunonoka kwekliniki kunononoka kwekugutsikana kwepfungwa kana mukugadzirisa unyanzvi hwekuzvida-zera huripo, hutsika hunochinja (kunze kwekukurukurirana kwevanhu), uye chido pamusoro pezvakatipoteredza muhuduku.
F. Mhedzisiro haisati yasangana kune imwe yakashata Inokurudzira Dambudziko Rokukura kana Schizophrenia.
Kucherechedza-Kukanganisika / Kushaya Matambudziko (ADHD)
Inattention - inobvisa basa nyore nyoreKunyengera - inoratidzika kufamba-famba nguva dzoseKushushikana - inokurumidza kuita zviito zvinoitika panguva iyo pasina kutanga kufunga nezvazvo
DHD Risk Factors
Genetics Kusvuta fodya, kushandisa doro, kana kushandisa zvinodhaka panguva yekuzvitakura Kunyatsoona nezvehutachiona hwehupenyu panguva yekuzvitakura Kuisa pachena kune zvinokonzera zvakatipoteredza, zvakadai sekukwirira kweutungamiri, pazera remakore Kuderedza kuberekwa pfungwa kukuvadzwa
Developmental Screening
www.cdc.gov/ncbddd/autism/hcp-screening.html
Primitive Reflexes
Moro Spinal Galant
Asymmetrical Tonic Neck Reflex
Symetrical Tonic Neck Reflex
Tonic Labrynthine Reflex
Palmomental Reflex
Snout Reflex
Kurapa Kwekuvandudzwa Kwekuvandudza
Kugadzirisa chero zvipi zvacho zvinoramba zvichengetedzwa
Dzidzisa vabereki nekupa nzvimbo yakarongeka
Kukurudzira uropi kuenzanisa mabasa
Taura zvinonzwisisika zvekudya uye kubvisa zvokudya zvinokonzera zvinetso
Bata chirwere chevarwere - probiotic, glutamine, nezvimwe.
Chiremba Acute-Onset Neuropsychiatric Syndrome
(PANS)
Kakawanda kudengenyeka kweOCD kana zvakanyanya kuzvidya kudya kudya
Zviratidzo hazvisi zviri nani zvinotsanangurwa neyeurologic inozivikanwa kana chirwere chekurapa
Uyewo zvimwe zviviri zvezvinotevera:
kufunganya
Kunzwa mupfungwa uye / kana kuora mwoyo
Kukanganisika, utsinye uye / kana kuzvipikisa zvakasimba
Kuzvibata / Kuvandudza kutonga
Kuora mwoyo kuchikoro kuchiita
Sensory kana motokari dzisina kunaka
Zviratidzo zveSomatic zvinosanganisira kuvhiringidzika kwehope, enuresis kana kuti urinary frequency
* Kutanga kwePANS kunogona kutanga nevatachiona vanopfurikidza pane strep. Inosanganisira zvakare kubva kune zvinokonzera zvakatipoteredza kana kuvhara muviri
Chirwere Chekuzvidzivirira Kwemakemikari Anosangana NeStreptococcus
(PANDAS)
Kuvapo kwezvinhu zvakakosha, kuvamanikidza uye / kana tic
Kumbomira kutanga kwezviratidzo kana nzira yekudzorera-yekudzorera yezviratidzo zvakasimba
Pre-pubertal onset
Kushamwaridzana ne streptococcal utachiona
Kushamwaridzana nezvimwe zviratidzo zveeuropsychiatric (kusanganisira chero yeiyo PANS accompanying zviratidzo)
PANS / PANDAS Miedzo
Swab / Strep tsika
Ropa kuedzwa kwe strep
Strep ASO
Anti-DNase B Titer
Streptozyme
Muedzo kune zvimwe zvinotapukira
MRI inofarira asi PET inogona kushandiswa kana zvichidikanwa
EEG
Nhema Hwenhema
Havasi vana vose vane strep vakakwira mabhiza
chete 54% yevana vane ruzivo yakaratidza kuwedzera kukuru kweAASO.
chete 45% yakaratidza kuwedzera kwe anti DNase B.
chete 63% yakaratidza kuwedzera kweiyo ASO uye / kana anti DNase B.
Kurapa kwePANS / PANDAS
Antibiotics
IVIG
Plasmaphoresis
Anti-Inflammatory protocol
Steroid mishonga
Omega-3's
NSAIDS
Probiotics
Kurapa Medical Clinic: Chiropractor (Yakarongedzwa)
VIDEO
Sources
InstituteKutarisa Kusakwana Kushaya Kunetseka Kusagadzikana.
Autism Navigator, www.autismnavigator.com/.
RoductionIntroduction kuAutism. Inopindirana Autism Network, iancommunity.org/introduction-autism.
Shet, Anita, et al. MmImune Mhinduro kune Boka A Streptococcal C5a Peptidase muVana: Zvinokonzeresa Kukura kweVaccion. Iyo Journal yeInfectious Diseases, vol. 188, kwete. 6, 2003, mapeji 809-817., Doi: 10.1086 / 377700.
Chii chinonzi PANDAS?
by Dr Alex Jimenez Clinical Neurology
El Paso, TX. Chiropractor, Dr. Alexander Jimenez anotarisa degenerative uye kuderedza zvirwere zvehutachiona hwezvirwere, zvirwere, zvirwere uye kurapa.
Degenerative & Demyelinating Zvirwere
Motokari yeNeuron Diseases
Motokari isina simba kunze kwekuchinja kwekunzwa Amyotrophic lateral sclerosis (ALS) ALS Variants Primary primary lateral sclerosis
Progressive bulbar palsy
Nhaka dzakagarwa dzinokonzera anterior runyanga cell degeneration Werdnig-Hoffmann chirwere mucheche
Kugelberg-Welander chirwere muvana uye vaduku vakuru
Amyotrophic Lateral Sclerosis (ALS)
Inobata varwere 40-60 yemakore emakore Kuparadza kune: Anterior horn cells
Cranial nerve motor nuclei
Corticobulbar uye maturakiti e corticospinal
Nhamba yepamusoro yemotokari yegeuroni (atrophy, fasciculations) NEpamusoro motokari yeuroni inowanikwa (spasticity, hyperreflexia)
Survival ~ makore matatu
Rufu runokonzerwa nekushaya simba kwebhururi uye kufema kwemapfupa uye hutachiona hunotapukira
ALS Variants
Kazhinji kacho zvinozopedzisira zvava kuchinja kuAlS pattern Primary Lateral Sclerosis Musoro wepamusoro motokari yeururoni inotanga kutanga, asi varwere vanozopedzisira vava nechepasi motokari neuron zviratidzo zvakare
Kupona kunogona kuva makore gumi kana kupfuura
Progressive Bulbar Palsy Kusarudzwa kunosanganisira musoro nemutsipa
Inherited Motor Neuron Conditions
Alzheimer's Disease
Inoratidzirwa nehutachiona hwehutachiona (zvikamu zve hyperphosphorylated tau protein) & beta-amyloid plaques
Kazhinji zvinoitika mushure mezera re 65
Hereditary risk factors Kuchinja-chinja mu beta amyloid gene
Epsilon 4 version ye apolipoprotein
kuongorora chirwere
Pathologic diagnosis ndiyo nzira chete yekunyatsoongorora chirwere chacho
Kufananidza kunogona kukwanisa kukonzera zvimwe zvinokonzera dhementia
Zvidzidzo zvekufungidzira zvinoshandiswa zvinogona kuwedzerwa kugadziriswa kuti zviongororwe zvinobatsira mune ramangwana
Chirongwa cheCSF kuongorora maitiro emapurotini uye beta amyloid inogona kuva yakakosha sekuongororwa mutsva munguva yemberi
Amyloid Zvibodzwa & Neurofibrillary Tangles
sage.buckinstitute.org/wp-content/uploads/2015/01/plaque-tanglesRNO.jpg
Nzvimbo dzeBongo Dzinobatwa neAlzheimer's Disease
Hippocampus
Kurasikirwa kwekuyeuka kwezvino
Posterior temporo-parietal association nzvimbo
Nyoro anomia & kuvaka apraxia
Nucleus basalis yaMeynert (cholinergic neurons)
Kuchinja mukuona maonero
Kufambira mberi
Sezvo nzvimbo dzakawanda dzekortical dzichibatanidzwa, murwere acharamba achinyanyisa kushaya njere, asi paresis, kurashikirwa kwezvinhu, kana kuonekwa kwemafupa aripo.
Treatment Options
Mishonga inhibit central central nervous system acetylcholinesterase
Donepezil Galantamine Rivastigmine
Aerobic Exercise, 30 maminitsi zuva nezuva
PT / OT kuchengetedza mabasa ehupenyu hwezuva nezuva
Antioxidant uye anti-inflammatory therapies
Muchikwata chepamusoro, zvingada nguva yakazara, mumusha wekutarisira
Vascular Dementia
Cerebral arteriosclerosis inotungamirira kune chirwere
Mwoyo murefu uchave wakanyora zvinyorwa zvepfungwa kana zviratidzo zvekurwadziwa (spasticity, paresis, pseudobulbar palsies, aphasia)
Inogona kubatanidzwa neAlzheimer's disease kana zvichienderana ne-amyloid angiopathy
Frontotemporal Dementia (Hosha ye Pick)
Familial
Inosangana nechemberi uye nguva dzemulobes
Inogona kuonekwa pamafungidziro kana kufambira mberi kunowanikwa munzvimbo idzi
zviratidzo
Kusateerera
Unhu hwakashata
Kushungurudzika Kushamwaridzana nemafambiro asina kunaka Kushushikana
Matambudziko emutauro
Kazhinji hapana chiyeuchidzo kana nzvimbo dzakaoma
Pathology inoratidza miviri ye Pick mukati me-neurons
Migumisiro mukufa mu 2-10 makore
Sarudza Bodies / Cytoplasmic Inclusions
slideplayer.com/9467158/29/images/57/Tonga+miviri+Silver+stain+Immunohistochemistry+for+Tau+protein.jpg
mabatiro
Antidepressants
Sertraline Citalopram
Rambai mishonga inogona kukonzera kuora mwoyo kwepfungwa kana kuvhiringidzika
Sedatives Benzodiazepines
kusimbisa muviri
Lifestyle modification Kuchinja maitiro therapy
Parkinson Disease
Inogona kuitika chero ipi zvayo, asi ishoma vasati yava nemakore 30, uye inowedzera kuwanda kunowedzera kune vanhu vakura
Unyanzvi hwekuzvarwa asi hunogonawo kunze kwemhuri
Inogona kukanganiswa nezvimwe zviitiko zvezvakatipoteredza
Kubudisa 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
Mishonga inobereka zvinodhaka zvakanyanya radicals
Inobata zvinyorwa zvinyorwa zvinyorwa
Dopaminergic neurons
Pazvirwere, kuvapo kweLeby Bodies
Kuunganidza alpha-synuclein
Lewy Bodies
scienceofpd.files.wordpress.com/2017/05/9-lb2.jpg
Zviratidzo zvePasinsinism
Rigidity (dzose ndege)
Passive ROM
Kushingaira kushingaira
Ive iine cogwheel zvakasikwa nekuda kwekudengenyeka kwezviratidzo
Bradykinesia
Kuderera kwekufamba
Kusakwanisa kutanga kufamba
Kusununguka
Kuzorora kudedera (illpill-rolling )
Yakasikwa nekuscillation kwemasimba emasimba anorwisana
Postural defects
Anteriorly flexed (yakakotama) kugadziriswa
Kusakwanisa kubhadhara zvinokanganisa, zvichikonzera kugadziriswa
Mask-kufanana nemaitiro
Dambudziko rekushaya utano hwemwoyo
Gare gare mukufambira mberi, nekuda kwechimiro chakaipa kuunganidza
Pathology
Kushayikwa kweDopamine mu striatum (caudate uye putamen) yebasal ganglia
Dopamine inowanzova nemigumisiro yekukurudzira denderedzwa yakananga kuburikidza nebhasal ganglia, nekudzivisa nzira isina kukodzera
Carbidopa / Levodopa
Kunyanya kurapwa kwakajairika ndeyomushonga unobatana
Levodopa
A dopamine anopandukira anoyambuka ropa-uropi hunopesana
Carbidopa
Dopamine decarboxylase inhibitor iyo isingayambuki BBB
Amino acids ichaderedza kubudirira (kukwikwidza) saka mishonga inofanira kubviswa kubva pamaprotini
Kurapwa kwenguva refu neCarbidopa / Levodopa
Simba remurwere rekuchengetedza dopamine rinodzikira nekushandisa mishonga uye nekudaro kuvandudzwa kubva kumishonga kunogara kwenguva pfupi uye ipfupi nguva iyo mushonga unoshandiswa
Nokufamba kwenguva zvinogona kukonzera kupararira kweiyo dopamine receptors
Peak-dose dyskinesia
Kushandiswa kwenguva refu kwenguva inoshungurudza pachiropa
Mimwe migumisiro inogona kusanganisira kunyorera, hypotension uye kukonzera
Other Treatment Options
Mishonga
Anticholinergics
Dopamine agonists
Dopanime breakdown inhibitors (Monoamine oxidase kana catechol-O-methyl transfase inhibitors)
High dose glutathione
Kuchengetedza ubongo zvinoshanda neuro-rehab maitiro
Vibration
Retropulsive stimulation
Kudzokorora reflex kukurudzira
Targeted CMT / OMT
Multiple System Atrophy
Zviratidzo zvePalinson Disease zvakabatanidzwa nechimwe kana zvinotevera zvinotevera:
Pyramidal zviratidzo (Striatonigral degeneration)
Autonomic dysfunction (ShyDrager syndrome)
Cerebellar kuwana (Olivopontocerebellar atrophy)
Kazhinji hazviiti zvinoenderana nehutachiona hwePalinson Disease
Progressive Supranuclear Palsy
Kufambira mberi kunofambira mberi kunosanganisira tau mapuroteni munzvimbo dzakawanda kusanganisira rostral midbrain
Zviratidzo zvinowanzotanga kusvika kumakore 50-60
Gait difficulty
Inokosha dysarthria
Voluntary vertical gaze rakaoma
Retrocollis (kukurumidza kuwedzera kwemutsipa)
Yakanyanya dysphagia
Emotional lability
Unhu hunochinja
Kuziva njodzi
Hazvipindure zvakanaka kumushonga wep PD
Kuparadzanisa Lewy Muviri Wezvirwere
Kufambira mberi kwemagariro evanhu
Kukurukurirana kwakanyanyisa uye kukanganisa kunokanganisa
Kusanganiswa
Parkinsonian zviratidzo
nemultiple sclerosis
Multiple machena mutsara mutsara (makanda ekutsvaira mvura) muCNS
Inoshandiswa muhukuru
Zvakanaka-cirscribed
Visible paMRI
Maziso emagetsi anowanzoonekwa
Nzira dzeropa dzinenge dzisingabatanidzwi
Kazhinji kune vana vari pasi peCNUMX, asi kazhinji inopa vasati vava nemakore 10
Utachiona hunokonzerwa nehutachiona hunoita kuti mutezo wemuviri unofanirwa nehutachiona husingazivikanwi nehutachiona-myelin antigen
Zvirwere zvinotapukira uye zvekudzivirira zvirwere zvinobatsira
Mhando dze MS
Primary PR progressive MS (PPMS)
Secondary progressive MS (SPMS)
Kudzokorora kunokwana multiple sclerasis (RRMS)
Nyaya inowanzozivikanwa
Inogona kukura zvakasimba, zvisingabvumirwi sezviri kugadzirisa uye kudzoka
Pakupedzisira inova seSPMS
Optic Nerve Kubatanidzwa
Mu 40% yematambudziko emu MS
Pain uye maziso omeso
Kutarisa kusvibiswa mumunda (central kana paracentral scotoma)
Funduscopic kuongorora
Ngaratidze papilledema kana ibwe rinosanganisira optic disk
Ngaparege kuonekwa isingaiti kana mapepa ari shure kwe optic disk (retrobulbar neuritis)
Medial Longitudinal Fasciculus Kubatanidzwa
Kuodzwa mwoyo kweMLF kunobata mukati mekuchengetedzeka kwechirimbuzi ophthalmoplegia
Munguva yekutarisa kwepamusoro pane peresis yemirairo yepakati uye nystagmus yemaziso akasiyana
Convergence inoramba ichitsvaga
Zvimwe Zvingaita MS Symptoms
Myelopathy
Spastic hemiparesis
Matambudziko ane manzwiro ematurakiti (DC-ML)
Paresthesias
Cerebellar kubatanidzwa
Ataxia
Dysarthria
Vestibular system inobatanidza
Kusanzwisisa
Mild vertigo
Nystagmus
Tic douloureux (trigeminal neuralgia)
Lhermitte chiratidzo
Kupfura kana kutinhira kunotaridzwa kunonzi trunk uye nhengo pamutsipa wehove
Kuneta
Kushamba kutsva kunowedzera zviratidzo
Kusiyana Kwokufunga
Multiple emboli uye vasculitis
Inogona kuonekwa sechinhu chakachena chena pamutemo weMRI
Central nervous system sarcoidosis
Inogona kubvisa reversible optic neuritis nedzimwe zviratidzo zveCNS
Whipple chirwere
Zvirwere zvinopisa
Kuita maziso omeso
Vitamini B12 kukwana
Dementia
Spasticity
Dorsal column
Maningovascular syphilis
Multifocal CNS kukuvadza
CNS chirwere cheLyme
Multifocal chirwere
Kusiyanisa Kuongororwa: Kuongorora Kuongorora
Kuyera ropa kunogona kubatsira kusiyanisa
Kuzara ropa kuverenga Antinuclear antibodies (ANA) Serum muedzo we syphilis (RPR, VDRL, nezvimwewo) Fluorescent treponemal antibody test Lyme titer ESR Angiotensin inoshandura enzyme level (kusvika r / o sarcoidosis)
Diagnostic Studies Of MS
MRI uye uye pasina kusiyana
90% yematambudziko eSMS akaoneka MRI yakawanikwa
CSF zvakawanikwa
Kurema kwemononuclear white blood cells
Oligoclonal IgG bands
Kuwedzera globulin kuhuwandu hwe albumin
Izvi zvinoonekwawo mu 90% yematambudziko emu MS
Kuwedzera myelin maitiro emuprotein mazinga
Prognosis
Avhareji kupona mushure mekuongororwa i ~ 15 kune 20 gore
Rufu runowanzobva kune hutachiona hwepamusoro uye kwete nekuda kwemigumisiro yechirwere pachayo
Sources
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
by Dr Alex Jimenez Clinical Neurology
Chirwere chinonzi cerebrovascular chikwata cheboka rakasarudzwa remamiriro ezvinhu anogona kutungamirira kumigumisiro yecherebrovascular / s, kureva Kurohwa . Izvi zviitiko zvinokanganisa kuwedzerwa kweropa nemidziyo kuuropi. Iine akuvhara, kukura, kana kuparara Zvinoitika, izvi zvinodzivirira maseru ehuropi kubva pakuwana oxygen yakakwana, inogona kukonzera kukuvara kwehuropi. Zvirwere zveCerebrovascular zvinogona kukura nenzira dzakasiyana. Izvi zvinosanganisira yakadzika vein thrombosis (DVT) uye atherosclerosis
Mhando dze chirwere cheperebrovascular: Stroke, kurwisa kwechikafu chinokanganisa , aneurysm, uye vascular malformations
MuAmerica cerebrovascular disease ndiyo yechishanu inowanzokonzera rufu.
Cerebrovascular Disorders
The Brain
Inoita ~ 2% yechipimo chemuviri
Maakaunzi e ~ 10% yemuviri wekushandisa oxygen
Maakaunzi e ~ 20% yemuviri wekushandisa glucose
Inogamuchira ~ 20% yemutambo wemoyo
Paminiti, inoda ~ 50-80cc yeropa pamusana pe100g ye grey nyaya yehuputi tissue uye ~ 17-40cc yeropa pa 100g yemuchena
If ropa kuuropi iri <15cc pa100g yetishu, paminiti, kusagadzikana kweurourogic kunoitika
Sezvo nemasukisi ose, iyo yakareba iine ischemia, zvinowanzove zviripo kuva sero rufu uye necrosis
Uropi hunoenderana nehupenyu hunogara huchigadziriswa, husina kuvharwa we okisijeni uye glucose
3-8 maminitsi ekumanikidzwa kwemwoyo kunogona kukonzera kukanganisa kwepfungwa dzisingagoneki!
Autoregulation In The Brain
Simba rinokonzera hutachiona hunokonzera kushanda kwehutachiona hwemhepo kuitira kuti ropa rakawanda riwedzere kuuropi
Uropi hunogona kukonzera okisijeni yakakwana kubva muuropi kana systolic inokonzera 50 mmHg
Atherosclerotic narrowing inogona kuita kuti vasedilation isashandise kuedza kuderedza kudzvinyirira zvakanyanya
Kuwedzera kweropa rega kunogona kukonzera vasoconstriction, kuderedza mikana yekushaya ropa
Kana systolic kumanikidza avhareji> 150 mmHg kwenguva yakareba, muripo uyu ungatadza
Yakabatwa nehutachiona hwekudzivirira
Kupa Ropa KuMusoro
madeinkibera.com/lingual-arterie-anatomie
Collateral Circulation
Mukufamba kwenguva pfupi kufambira mberi kwakadai seatrosclerotic thrombosis, kushambadzirwa kwezvikwata kune nguva yekukura
Denderedzwa yaWotis inobatanidza hurongwa hwe carotid uye buslar
Anterior uye posterior kutaurirana magetheni inopa kubhadhara
Anastomoses pakati pehutachiona hukuru uye cerebellar arteri mune vamwe vanhu
Yemukati neyekunze carotid arteri yekubatanidza kuburikidza neiyo ophthalmic & maxillary arteri
Circle Of Willis
Inobatanidza vertebrobasilar system nechomukati carotid system
Paunenge uchipa rubatsiro runobatsira runoshandiswa, ndiyo nzvimbo inonyanya kunetseka kuBerry Aneurysms iyo inogona kukonzera kuparara kwepakati
en.wikipedia.org/wiki/Circle_of_Willis
Kuwedzerwa kweRopa KuBongo
teachingmeanatomy.info/neuro/vessels/arterial-supply/
Maxillary & Ophthalmic aa.
Cerebrovascular Disorders
~ 700,000 vanhu vakuru muUnited States vane chirwere gore negore
Chechitatu chinowanzokonzera rufu muUnited States ~ 2 mamiriyoni evanhu akaremara nekuda kwekurohwa
Nezvinozivikanwa zvikuru kune vanhu vakura Occlusive / Ischemic Disease 80% yezvisungo zvose
Nzvimbo yakawanda inowanzozivikanwa yekusvibiswa iri mukati memutambo wecarotid kumusoro kwepamusoro pezvakagadzirwa zvemahara carotid a.
Atherothrombotic
Embolic
Muduku muduku
Hemorrhagic Disease
Occlusive / Ischemic Stroke
Inogona kunge yakakonzerwa netiyiti kana mishonga yemazuva Arteri occlusion yakawanda zvikuru
Nekuda kwekushayikwa kweropa & oksijeni kupihwa kunosvika kune imwe nzvimbo yeuropi Kamwe kamwe-kamwe kunotanga kukanganisa kweurosi, kuwirirana nekugoverwa kweteri chaiyo Kukanganisa kuchasiyana zvinoenderana nekuti kugoverwa kwetsinga kwakakanganiswa
Venous Occlusion
Hyperviscocity nemvura
Thombocytosis
Yakasvibirira tsvuku kana masero masero eropa anoverenga
Polycythemia
Hypercoagulability Elevated homocysteine
Kuramba kwenguva refu kana kufamba ndege
Genetic clotting factor disorders
Kuberekwa
kenza
Hormone kutsiva & OCP kushandiswa
Atherothrombotic
Kukanganisa kweeurologic kunogona kuva kwenguva pfupi kana kukura zvishoma nezvishoma kupfuura nguva Zvimwe zvinokonzera / marudzi: Dissection ye tunica intima uye tunica adventitia
Zvinogona kuitika kune varwere vaduku vane zvirwere zvinogadzirisa zvirwere
Zvekuzvimba zvinhu zvinochengeterwa & kuvaka mumidziyo masvingo
Oxidized LDLs inopa mudziyo masvingo
Embolic
Zvinokanganisa neurologic zvingangodaro zvichingoerekana zvaitika
Akabvisa tissue kubva pakutsvaga kwe tunica intima uye tunica adventitia
Chero chipi nechipi chinoputika chinyorwa chinogona kunge chichivhara / kupfiga chiedza chemidziyo miduku
Chikepe Chidiki
Lipohyalinosis Vessel rusvingo micro-trauma & ballooning
Amyloid Angiopathy Kuunganidza mapuroteni emamyloid mumadziro emadziro
Zvimwe zvakajairika muvarwere> makore makumi matanhatu nemashanu ekuberekwa
Zvinokonzera kuderedza (kutungamirira kune ischemia) asi kunogonawo kukonzera mhepo fragility (inotungamirira ku kuora ropa)
Yakabatana nechirwere cheAlzheimer
Kuvhiringidza Spasmotic
Zvinokonzerwa Nengozi Zvokuda Kuita Simba
Hypertension Diabetes mellitus Cardiac kusakanganisika Kurudyi-kuruboshwe (Patent foramen ovale, VSD, tetralogy yenhema, etc)
Atrial fibrillation
Chirwere chevhavha / mapapiro emwoyo mavheti
Nguva yakwegura kufutisa Hyperlipidemia Kunyanya high LDL uye pasi peHDL
Sedentary lifestyle Sodya / Fodya fodya High oxidation status Elevated homocysteine Yakapihwa kune yakaderera folic acid, B6 & B12 mamiriro
Inopindirana neLDL cholesterol
Hyperviscocity uye hypercoagulability inotaura sezvinoratidzwa pane slide yapfuura
Chirwere cheIschemic Chidiki (TIA)
Zvikamu zvakakwana zvekudzoka kwehutano hwehutano hwepfungwa nekuda kwekusagadzikana kwevasculasi zvinowanzogara pasina maminitsi e30 panguva imwechete
Dzimwe nguva dzinogona kupedza maawa 24 kana kupfuura
Hafu yevarwere avo vanotambura nechikwata chakazara chekare chakange chine nguva shoma ischemic attack (s)
20-40% yevarwere vane TIA vanoramba vaine chirwere chakakwana
Mukati zvakakosha kuzivisa varwere vane TIAs kuti vangave vakakwanisa kunyatsogadziriswa uye kuchinjwa kwezvinhu zvinowedzera kuderedzwa
Nhoroondo Yeinononoka Neurologic Dhefisiti Mune Murwere> 45 y / o
DDx
TIA kazhinji dx
Migraine
Focal seizures
BPPV
Meniere s
Kuderedza zvirwere
Temporal arteritis
Hypoglycemia
Tumor
Arteriovenous malformations
Carotid Artery Disease
Yakazara yakasungwa systolic mheremhere inzwiwa pamusoro pecaritid arteri inogona kuratidza carotid stenosis
Zvinoda duplex ultrasound kuongorora
Maronda anoderedza lumen> 70% inogona kukonzera ischemia
Zvakawanda zvekugadzirisa carotid hazvikonzeri ischemia nekuda kwekukurumidza kufambira mberi kunobvumira kushandiswa kwekuchengetedzwa kwekugadziriswa kuti ibudirire pamwe chete
Kukurumidza kugadzira occlusions kana emboli kunogona kuburitsa matambudziko ne <70% stenosis
Kupindira kwekuvhiya kunofanirwa kutariswa kune varwere vane> 70% stenosis uye zviratidzo zveTIA
Occlusive Stroke
Kana paine kutanga kwechikonzero chakasimba chechirwere chepfungwa, murwere anofanirwa kuva neCCT kuti atonge kunze kwehutachiona Kana kuora ropa kuchibviswa kunze, mishonga inonzi plasminogen activator inofanira kupiwa mukati mekutanga kwemaawa 4.5 Hazvifanirwi kupiwa mushure meizvi nokuti inogona kuwedzera njodzi yekubuda ropa panguva yekushandurwa kwehuputi tissue
Mushure mekutanga kwekutanga, tarongedzo yekrombolysis kana kushandiswa kwema mechanical ye embolus
Intracranial Hemorrhage
Inenge 20% yemakumbo emakumbo Ha HA yakajeka kana kurutsa zvinoratidza kuora kwemvura pamusoro pekushandiswa Mhando mbiri Kunokonzera kusagadzikana kwekushaya ropa Hypertension
Arterial aneurysms
Arteriovenous malformations
Kusvibisa zvinetso
Chikepe chinopera simba nekuda kwekunyengedzera kwemajozi
Kutambudzika
Aneurysm Sites
Intraparenchymal hemorrhage 50% - Matavi anonzi Lenticulostriate emutambo wepakati cerebral artery
Unoshushikana ne-putamen nekunze capsule 10% - Matavi anoputika anonzi posterior cerebral artery
Inobata thalamus 10% - Matavi anoputika e-cerebellar artery yakakwirira
Inobata cerebellum 10% - Paramedian mapazi e-buslar artery
Inokanganisa buslar pons 20% - Mitambo yakasiyana inobata nzvimbo dzemavara machena
Subarachnoid homorrhage Bherry aneurysms pakukurukura arteri masangano
Kuderedza kuora Kwemhepo
Thrombocytopenia
Leukemia
Kunyanya anticoagulant therapies
Zvinokonzerwa Nengozi NeHemorrhagic Stroke
Hypertension
Arterial aneurysms
Arteriovenous malformations
Kusvibisa zvinetso
Chikepe chinopera simba nekuda kwekunyengedzera kwemajozi
Head trauma
Zviratidzo zveSproke: Dzidzisa Vatano FAST
chrcsf.org/expert-tips-to-help-with-detecting-the-early-signs-of-stroke/
Zviratidzo Zvenguva Zvose
Vertigo
Kushamwaridzana kana kurasikirwa kwemaonero
Ataxia
Diplopia
Kubatanidzwa kana kusagadzikana kwekunamatira uye kushaya motokari
Syncope
Kushaya simba mukuparadzirwa kwemhepo inokonzera mutsara imwe rutivi rwemusoro nemutambo unonzi hemiparesis (utachiona hunokanganisa brainstem)
Kukuvadzwa kune sensory cranial nerve & Horner's syndrome kune rimwe divi remusoro uye kurasikirwa kwe contralateral. marwadzo uye kutonhora kunzwa mumuviri (lateral brainstem kukuvara)
Zviratidzo Zvenguva refu Ichitenderera Kunzvimbo Yakatarisana
Monocular visual obscuration (amaurosis fugax) inokonzera retinal ischemia
Contralateral hemiparesis
Kukanganisa kweHemisensory
Mavara ekuona mashoma
Dysphasia
Inogamuchira aphasia (Wernicke s nharaunda lesion)
Anotsanangura aphasia (Broca s nzvimbo lesion)
Contralateral kukanganwa (pane-pineetal parietal lobe lesion)
Matambudzikowithinitiationofmovement (Supplementarymotorcortex lesion)
Dambudziko nekutarisa nokuzvidira kumativi akasiyana (Frontal eye field lesions)
Mhedziso yenguva pfupi yekuyeuka
Ubongo-Stem Syndromes
roho.4senses.co/stroke- syndromes / zvakajairika-sitiroko- syndromes-chitsauko-9-bhuku-rekurohwa-sitiroko.html
Stroke Recovery
Rehab inoda kutarisana nenharaunda yehupi hutachiona hwakashungurudzwa nemuroyo Kutaura kwekutaura
Chiremera chekushanda kwemakumbo
Kuenzanisa uye gadziriro maitiro
Inokurudzira neuroplastic restructuring Zviratidzo zvinogona kuvandudzwa mukati mezuva rekutanga re5 nekuda kwekuderedza edema Edema inogona kukonzera herniation kuburikidza ne foramen magnum iyo inogona kukonzeresa kukanganiswa kwehuropi uye kufa - varwere vane dambudziko iri vangangoda craniectomy (yekupedzisira kushandiswa)
Sources
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
by Dr Alex Jimenez chisingaperi Pain , Clinical Neurology , Hutano hwepfungwa , Nerve Injury , Neuropathy
Mushure mokuongorora kushaya mishonga, kuongorora mumuviri, nhoroondo yevarwere, x-rays uye chero ipi zvayo yekuongorora kuongororwa, chiremba anogona kuraira imwe kana zvimwe zvezvinotevera kuongororwa mutsva kuti atarise midzi yeanokwanisa / yekufungidzirwa neurological disorder kana kukuvara. Izvi zvinowanzobatanidza neuroradiology , iyo inoshandisa zvishoma zvinyorwa zve-radioactive kuti zviongorore chimi chebasa uye sarudzo uye ordiagnostic imaging , iyo inoshandisa magetsi nemagetsi ekuongorora chimi chebasa.
Neurological Studies
Neuroradiology
MRI
MRA
MRS
fMRI
CT inoongorora
Myelograms
PET inoongorora
Vamwe vazhinji
Magnetic Resonance kuri (MRI)
Inoratidza nhengo kana zvinyoro zvinyoro zvakanaka
Kusiyana kweMRI
Magnetic resonance angiography (MRA)
Ongorora ropa richiyerera mumariti
Tsvaga zvinyorwa zvisingabatsiri uye kusagadzikana kwepascular
Magnetic resonance spectroscopy (MRS)
Chengetedza kukanganisa kwemakemikari mune hutachiona hweHIV, kurohwa, kuora musoro, coma, chirwere cheAlzheimer, tumor, uye multiple sclerosis
Inoshandiswa magnetic resonance imaging (fMRI)
Sarudza nzvimbo chaiyo yeuropi iyo basa rinoitika
Computed Tomography (CT kana CAT Scan)
Inoshandisa kuwirirana kwe-X-rays nekombiyuta yekombiyuta kuti ibudise zvitsvene, kana axial, mifananidzo
Anoratidza mapfupa zvakanyanya zvakanaka
Inoshandiswa apo kuongororwa kweuropi kunoda kukurumidza zvakadai sekufungidzirwa ropa uye fractures
Myelogram
Kusiyanisa dhayi pamwe chete neC CT kana Xray
Yakawanda inobatsira pakucherechedza rwonzi rwomusana
Stenosis
Tumor
Nerve root injury
Positron Emission Tomography (PET Scan)
Radiotracer inoshandiswa kuongorora metabolism yemaviri kuti ione kuchinja kwezvinhu zvipenyu kune imwe nguva kupfuura dzimwe dzidzo dzokudzidza
Yakashandiswa kuongorora
Chirwere cheAlzheimer
Chirwere chePalinson
Chirwere cheHuntington
pfari
Cerebrovascular accident
Electrodiagnostic Studies
Electromyography (EMG)
Nerve Conduction Velocity (NCV) Studies
Zvakavhiringidzika Zvimwe Zvidzidzo
Electromyography (EMG)
Kuziva zviratidzo zvinokonzerwa nekudengenyeka kwemakumbo emasumbu
Inogona kuyerwa kuburikidza ne:
Ganda kumusoro electrodes
Haana kushandiswa pakuongorora zvirongwa, zvimwe zve rehab uye biofeedback
Nyeredzi dzakaiswa zvakananga mukati memusuru
Kazhinji kumakiriniki / kuongororwa EMG
Zvinyorwa zverepolarizations zvinogona kuva:
Zvinowanzoitika
Basa rekusimudzira
Mugumisiro wekuzvidira musimba kuputika
Misungo inofanira kunge iine magetsi yanyarara pazororo, kunze kwepombi yekupedzisira
Mushandi anofanira kudzivisa kuiswa mumupfuti wemagetsi
Zvichida 10 pfungwa dzakasiyana mumusumbu dzinotaridzirwa nenzira yakarurama
nzira
Nyore inopindirwa mumusungo
Basa rekusimudzira rakanyorwa
Kunyarara kwegetsi kwakanyorwa
Voluntary muscle contraction yakanyorwa
Kunyarara kwegetsi kwakanyorwa
Maitiro makuru ekudzivirira akanyorwa
Samples Akaunganidza
tsandanyama
Inotarisirwa nehutano hwakafanana asi yakasiyana nemidzi yemidzi
Inotarisirwa nehutano humwechete asi hutano hwakasiyana
Nzvimbo dzakasiyana-siyana pamwe chete nematambudziko
Inobatsira kusiyanisa hutachiona chechionda
Motor Unit Potential (MUP)
Amplitude
Kuwanda kwehutundu hwemisumbu inosungirirwa kune iyo motokari yemukati
Kunyoresa kweMUP
Nzira yekudzidzira inogona kuongororwawo
Kurambidza kubhadhara kunogona kuratidzira kurasikirwa kwezvitima mukati memutsipa
Kutanga kushanyira kunoonekwa mune myopathy, uko MUPs inowanzove yakaderera nguva shoma
Kuwedzerwa kwemamita uye nguva inogona kuva mugumisiro we reinnervation mushure mekuregererwa kwekugara
Kuderedza kuwanda kwezvikamu zvakasiyana-siyana mumutsara kunogona kukonzera chizere chakazara chekuita mutsara uye naizvozvo hakuna kuunza MUP kuverenga, zvisinei kuchinja kukuru muMUPs kunongowanikwa nekukuvadza kune axon, kwete myelin
Kukuvadza kunheyo yenheyo yepamusoro pamusoro pehupamhi yemotokari yeururoni (yakadai nemukomana wepervical cord trauma or stroke) kunogona kukonzera kuora muviri kwakakwana zvishoma zvisina kumira painete reEG
Yakasvibiswa Muscle Fibers
Zvicherechedza sechiratidzo chemagetsi chisina kujairika
Kuwedzera kwekuita basa rekunyora kunogona kuverengwa mumavhiki mashomanana ekutanga, sezvo inowedzera kunyanya kugadziriswa
Sezvinoita mishonga yemasikironi inowedzera makemikari anononoka inotanga kubudisa basa rekuita zvekupora
Kufara Kwezvakaitika
HAKASI kuitika mumasikironi akafanana
Kukwikwidza hakugone kuonekwa neziso rakashama asi kunoonekwa pa EMG
Kazhinji inokonzerwa nehutachiona hwehutachiona, asi inogona kubudiswa nehutachiona hwehutachiona hwakanyanya kana pane kukanganisa kumakumbo emotokari
HASI kuitika mumasikirini anowanzoshanda
Kurasikirwa kwepachivande kunokonzerwa nekuwedzera kwemuviri wechipfuva
Zviwanikwa zvefibrillations uye majeko akanaka akasimba ndiyo chiratidzo chinonyatsovhiringidza chekuvhiringidzika kune motokisi yemotokisi kusvika mushure mushure mevhiki imwe kusvika kumwedzi 12 mushure mekuparadzwa
Kazhinji inonzi acute mumishumo, kunyangwe ingangove mwedzi inoonekwa mushure mekutanga
Ichazonyangarika kana kune kukwana kwakakwana kana kuti kusagadzikana kwehutachiona
Nerve Conduction Velocity (NCV) Studies
motokari
Miitiro inowanikwa muscle action potential (CMAP)
Sensory
Nzira sensory nerve action potential (SNAP)
Nerve Conduction Studies
Velocity (Speed)
Terminal latency
Amplitude
Tables ezvakanaka, yakagadziridzwa kwezera, urefu uye zvimwe zvinhu zvinowanika kuvaridzi kuti vaenzanise
Terminal Latency
Nguva pakati pekukurudzira uye kuonekwa kwekupindura
Kushungurudzwa kwemavara neuropathies
Kuwedzera kwechigumira latency kune imwe nzira yenzira
Velocity
Yakayerwa maererano ne latency uye zvipembenene zvakadai semakiromita
Ichitenderera pamadziro eadon
Uyewo unofanirwa nehupamhi hwe myelin sheath
Focal neuropathies yakatetepa myelin sheaths, inononoka conduction velocity
Mamiriro ezvinhu akafanana neCharcot Marie Tooth Disease kana Guillian Barre Syndrome inokuvadza myelin muhombe huru, kufambisa fiber
Amplitude
Axonal utano
Dhiyabhorosi neuropathies
CMAP uye SNAP amplitude yakavhiringidzwa
Diabetes Neuropathy
Yakawanda inowanikwa Neuropathy
Distal, symmetric
Kuodzwa kwemhepo uye kukuvadza kwe-axonal saka kukurumidza uye kukura kwekutengesa zvose zvakabatwa
Zvakavhiringidzika Zvimwe Zvidzidzo
Somatosensory yakabviswa zvinogona (SSEPs)
Yakashandiswa kuedza nhungurudzo dzemakumbo mumakumbo
Kuonekwa kunokonzerwa nemikana (VEPs)
Yakashandiswa kuedza nhungurudzo dzemanzwiro ezvioni
Brainstem auditory yakavhiringidza mikana (AEPs)
Yakashandiswa kuedza nhungurudzo dzenheyo dzemabhuku ekuongorora
Nzvimbo dzepamusoro dzakanyorwa kuburikidza ne-low-impedance surface electrodes
Zvinyorwa zvinyorwa mushure mekunge zvadzokerazve kune zvinokonzerwa nemanzwiro
Inobvisa kumashure noise
Inogadzirisa mitsva sezvo zvigone zviduku uye zvakaoma kuona kunze kwebasa rekuita
Maererano naDr. Swenson, munyaya yeSSEPs, zvishoma ne256 zvinowanzodiwa kuitira kuwana mhinduro dzakatendeka, dzinogadziriswa
Somatosensory Akavhiringidza Maitiro (SSEPs)
Kunzwa kubva mumasumbu
Kubata uye kukurira zvinogadziriswa paganda uye mukati maviri
Zvishoma kana zviripo marwadzo Mupiro
Miganhu yekugona kushandisa kuongororwa kwemarwadzo ekurwadziwa
Velocity uye / kana matanho ekuchinja zvinogona kuratidza hutachiona
Kuchinja kukuru chete kunokosha kubvira SSEPs inowanzosiyana zvikuru
Inobatsira pakushandura kwepraoperative uye kuongorora kufungidzira kwevarwere vane chirwere chakakomba chinokonzerwa neuropi
Hazvibatsiri pakuongorora radiculopathy semunhu mumwe musinga midzi haigoni kuonekwa nyore nyore
Zuva Rekushandisa
Ita zvinopfuura 10-20 milliseconds mushure mekusimudzirwa kwemagetsi
Mhando mbiri
H-Reflex
Anonzi ainzi Dr. Hoffman
Chokutanga chakatsanangura izvi zvinyorwa mu1918
Electrodiagnostic manifestation ye myotatic stretch reflex
Motokari inopindurwa yakanyorwa mushure mekushandisa magetsi kana kuti kutowedzera kushandiswa kwemisungo yakabatana
Chechipiki chete inobatsira pakucherechedza S1 radiculopathy, sezvo kufungidzira kubva mumutsipa we-tibial kutarisa surae kunogona kuongororwa kuti velocity uye amplitude
Zvimwe zvinyorwa zvekuti Achilles reflex kuedza
Inokundikana kudzoka nayo mushure mekukuvadza uye naizvozvo kwete semakiriniki anobatsira mumakororo anowanzobuda radiculopathy
F-Mhinduro
Saka akatumidzwa nokuti yakatanga kunyorwa mutsoka
Inoitika 25 -55 milliseconds mushure mekutanga kwekusimudzira
Pamusana pekudzivirira kuderedza dutu remhepo, inoita kuti zviratidzo zvemagetsi zvinyorwa
Haisi chokwadi chechokwadi
Migumisiro mune zviduku zvinokonzera musimba
Amplitude inogona kunge yakasiyana zvikuru, saka haisi yakakosha sevelocity
Kuderedza velocity kunoratidza kunonoka kwekutengesa
Inobatsira pakucherechedza hutachiona hwehutano hwehutano
Radiculopathy
Guillian Barre Syndrome
Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP)
Inobatsira pakuongorora demyelinative peripheral neuropathies
Sources
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
Zuva, Jo Ann. �Neuroradiology | Johns Hopkins Radiology.� Johns Hopkins Medicine Health Library, 13 Oct. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology/index.html.
Swenson, Rand. Electrodiagnosis.
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by Dr Alex Jimenez chisingaperi Pain , Clinical Neurology , Mamiriro Ekutongwa , Kutemwa nemusoro nekurapwa , Injury Care , Hutano hwepfungwa , Mitambo Injodzi , Mishonga , Whiplash
Mhedziso ndeyokukuvara kwehuropi hunoita kuti uropi hushande. Migumisiro kubva mukukuvara uku kazhinji kwenguva duku asi inogona kusanganisira headaches , zvinetso nekutungidzirwa, kurangarira, kuenzanisa nekubatana. Mhedziso kazhinji inokonzerwa nekurova kumusoro kana kushungurudzika kwechisimba kwe musoro uye kumusoro. Zvimwe zvinokonzera kukanganisa kwekuziva, asi vazhinji havaiti. Uye zvinokwanisika kuva nekugadzirisa uye kusazviziva. Mhedziso yakajairika mumitambo yekubatana, yakadai sebhola. Zvisinei, vanhu vazhinji vanowana kuzorora zvakakwana mushure mokunge mhirizhonga.
Concussions
Kushungurudzika kweBongo Kukuvara (TBI)
Kazhinji kacho kazhinji chigumisiro chemusoro dambudziko
Zvinogonawo kuitika nekuda kwekunyanyisa kukuru kwe musoro kana kukurumidza / kuderedza
Kukuvara kwakakomba (mTBI / mazano) ndiyo inowanzovhiringidzwa neuropi
Glasgow Coma Scale
Zvinowanzokonzera Mhedziso
Motokari kupopotedzana kana Makuvara emitambo bata chibharo Zvichida kana kuti nemaune kubudisa zvombo Impact nezvinhu
dziviriro
Kudzivirirwa kwekukuvadzwa kwakakosha kunogona kuve kwakakosha
Kurudzira Vatwere Kupfeka Makadhi
Kukwikwidza mitambo , kunyanya bhomba, hokey, bhora uye baseball
Kukwira bhiza
Kutakura mabhasikoro, motokari, ATV, nezvimwewo.
Kukwidzwa kwepamusoro kunobatsira sekumhanya kwedombo, zip lining
Kuchengetedza, snowboarding
Kurudzira Varwere Kuti Vafukidze Seatbelts
Kurukurai kukosha kwokupfekedza mabheji nguva dzose mumotokari nevarwere vako vose
Uyewo kukurudzira kushandiswa kwezvikwata zvinokodzera kana zvigaro zvevana kuti vaone kuti zvakakwana zvakakwana uye basa rebhanhire rechigaro.
Kutyaira Zvakachengeteka
Varwere havafaniri kumbofambisa apo vari pasi pesimba remishonga, kusanganisira mamwe mishonga kana doro
Usambotumira mameseji uye kutyaira
Ita Zita Zvakachengeteka Kwavana
Isai masuo emasuo uye mahwindo emawindo mumusha
Ngaive munzvimbo dzine zvinhu zvinotyisa, zvakadai segoldwood mulch kana jecha
Chengetedza vana nokungwarira, kunyanya pavanenge vari pedyo nemvura
Prevent Falls
Kuchenesa njodzi dzinokonzera dzakadai sedhizha dzakasununguka, kusina gwava pasi kana kuti kumigwagwa kwemafuro
Kushandisa nonslip mats mumabhati nepamusoro pedenga, uye kuisa mabheji pedyo neimba yega, tub and shower
Iva nechokwadi chezvikafu zvakakodzera
Kuisa zvinyorwa pamativi ose maviri ematanho
Kuvandudza chiedza kumusha
Balance training training
Balance Training
Soro rimwe chete
Bosu bhora kudzidzira
Core kusimbisa
Kuchengetedza kwebongo kuedza
Concussion Verbiage
Mhedziso kana mTBI (kukuvadzwa kwehuputi hwepfungwa)
mTBI ndiro izwi riri kushandiswa kakawanda mumamiriro ekurapa, asi kuongororwa izwi rinonyanya kuzivikanwa mumunharaunda nevanodzidzisa zvemitambo, nezvimwewo.
Aya mazwi maviri anorondedzera chinhu chimwechete chakakosha, mTBI ndiyo nguva iri nani yekushandisa pakushandisa kwako
Kuongorora Mhedziso
Yeuka kuti hapasi nguva dzose inofanirwa kuva kurasikirwa kwekuziva kuitira kuti pave nekugadzirisa
Post-Concussion Syndrome inogona kuitika pasina LOC zvakare
Zviratidzo zvekukwikwidza zvingasave zviri pakarepo uye zvinogona kutora mazuva kukura
Tsvaga ye48 post head kurira kukurudzira mireza matsvuku
shandisa Yakakosha kugadzirisa kuongorora (ACE) fomu kuunganidza ruzivo
Tora imaging (CT / MRI) sezvinodikanwa kana mabhii mutsvuku aripo
Red Flags
Inoda imaging (CT / MRI)
Musoro unowedzera kuipa
Murwere anoita seanotsumwa kana asingamutswe
Une kuoma kubvuma vanhu kana nzvimbo
Neck marwadzo
Seizure basa
Kurutsirazve
Kuwedzera kuvhiringidzika kana kutsamwa
Kusagadzikana kwetsika yekuchinja
Focal neurologic zviratidzo
Slurred speech
Kushaya simba kana kushaya simba mumagumo
Shanduka munharaunda ye pfungwa
Zviratidzo Zvinowanzovhiringidzika
Musoro kana kuti kunzwa kwekumanikidzwa mumusoro
Kurasikirwa kana kuchinjwa kwekuziva
Maziso akasvibiswa kana zvimwe zvinetso zvekuona, zvakadai sevana vanodzidza kana vasina kukwana
Kusanganiswa
Chizutu
Kuridza munzeve
Nausea kana kurutsa
Slurred speech
Kumbomira kupindura mibvunzo
Kurasika kurasika
Kuneta
Dambudziko rinowedzera
Kuenderera mberi kana kuramba kuchirikanwa mupfungwa kurasikirwa
Kukanganisika uye humwe unhu hunochinja
Kunzwisisa kujekesa uye ruzha
Matambudziko okurara
Maitiro anofamba, kushungurudzika, kuzvidya mwoyo kana kuora mwoyo
Matambudziko ekuravira uye kunhuwa
Mental / Behavioral Changes
Verbal outbursts
Kuputika kwepanyama
Zvakaipa kutonga
Kuita zvinhu zvisina kufanira
Negativity
Kuvhiringidzika
Kusateerera
Egocentricity
Rigidity and inflexibility
Kuipa maitiro
Kusava netsitsi
Kusava nechikonzero kana chiito
Kushungurudzika kana kufunganya
Zviratidzo Muvana
Mhedziso inogona kupa zvakasiyana nevana
Kunyanya kuchema kuchema
Kufirwa kwechido
Kurasikirwa kwemashoko mune zviduku zvemasikana kana mabasa
Nharo dzehope
Kudzora
Kusvibiswa
Kusagadzikana paumire
kukanganwa
Kurasika kurasika uye kukundikana kuumba zvirangariro zvitsva
Dzorera Amnesia
Kusakwanisa kuyeuka zvinhu zvakaitika vasati vakuvara
Nokuda kwekukundikana mukuyeuka
Anterograde Amnesia
Kusakwanisa kuyeuka zvinhu zvakaitika mushure mekukuvara
Nokuda kwekukundikana kwekuumba zvitsva zvitsva
Kunyangwe kukanganisa kukanganisa kurasika kunogona kunge kunopedzisira kuitika
Amnesia inogona kunge ichikwira ku 4-10 nguva dzakawanda kupedzisa kwezviratidzo uye kukanganisa kwemagariro zvinotevera kusangana kudarika LOC (pasi pemaminiti 1)
Dzokera Kutamba Kufambira mberi
Baseline: Hapana Zviratidzo
Sezvo danho rekutanga rekudzoka kuKuchengetedzwa kweMutambo, mutambi wacho anofanira kunge akapedza zororo remuviri uye rwekuziva uye asingave nekutarisana kwezviratidzo kwemaawa mashoma e48. Ramba uchifunga mupfungwa, mudiki mutambi wacho, kunyanya kurapa kurapa.
Danho 1: Chiedza Aerobic Activity
Chinangwa: Chete kuwedzera moyo wemutambi.
Nguva: 5 kune 10 maminitsi.
Zvinoitwa: Bhizimusi rekuvhimisa, kufamba, kana kubuda kwechiedza.
Kunyangwe pasina kusimudza kwekusimudza, kusvetuka kana kushanda nesimba.
Nhanho 2: Basa rakanaka
Icho Chinangwa: Mutumbi usina kukwana uye musoro.
Nguva: Yakaderedzwa kubva pakugara kwenguva yakawanda.
Zvinoitwa: Kuramba kwakanaka, kushanda kwenguva pfupi, kuenzanisa-kunyanzvi kwepamusoro motokari, uye kuenzanisa-kuwedzerwa weightlifting
Danho 3: Basa rakaoma, risina kubatana
Chinangwa: Kuwedzera zvakanyanya asi kusingatauri
Nguva: Swedera kunowanzoita tsika
Zvinoitwa: Kumhanya, kukwirira-kwakasimba kwakamira, kuchovha bhasikoro, mutambi wacho wenguva dzose wehuremu hwekusimudzira, uye asiri ehukama emitambo-akasarudzika mabhora. Iyi nhanho inogona kuwedzera chimwe chinhu chinonzwisisika kudzidzira kuwedzera kune maeerobic uye mafambiro ekufambisa akaunzwa muDanho 1 ne2.
Nhanho 4: Dzidzira & uzere nekubatana
Chinangwa: Dzokerazve zvakare mukutaurirana.
Danho 5: Kushinha
Chinangwa: Dzokera kumakwikwi.
Microglial Priming
Mushure memusoro wekutambudza ma microglial masero anonyorerwa uye anogona kuve akapfuura
Kuti urwise izvi, iwe unofanirwa kupindira kuputika kwechirwere
Kudzivirira kudzokorora musoro kunetseka
Pamusana pekugadzirisa mapepa emakumbo, kupindura kwekutsvaga-kunetseka kungave kwakanyanya uye kwakakuvadza
Chii Chinonzi Post-Concussion Syndrome (PCS)?
Zviratidzo zvinotevera kushungurudzika kwepamusoro kana kukuvadzwa kwakakomba kweuropi, izvo zvinogona kupera vhiki, mwedzi kana makore pashure pokukuvara
Zviratidzo zvinopfuurira kwenguva yakareba kudarika zvinotarisirwa mushure mokutanga kugadzirisa
Zvinowanzoonekwa kune vakadzi uye vanhu vezera remakore avo vanotambura zvikuru
Kuoma kwePCS kazhinji hakuwirirani nekuoma kwekukuvara kwemukoko
PCS Zviratidzo
Headaches
Chizutu
Kuneta
Kusvibiswa
kufunganya
kutadza kurara
Kutadza kwekufungisisa nekuyeuka
Kuridza munzeve
Blurry chiratidzo
Ruzha uye chiedza chekunzwa
Kazhinji, inoderera muvira uye kunhuwa
Mhedziso Inobatana Nengozi Zviitiko
Zviratidzo zvekutanga zvepfungwa pashure pokukuvara
Kuchinja kwepfungwa dzakadai seamnesia kana fogginess
Kuneta
Zvekare nhoroondo yemusoro
Kuongorora kwePCS
PCS inorwara yekuregererwa
Kana murwere achizadza nezviratidzo mushure mekukuvara kwemusoro, uye zvimwe zvinokonzeresa zvakatemerwa kunze => PCS
Shandisa zvidzidzo zvakakodzera zvekuedza nekufungidzira kuti utonge zvimwe zvikonzero zvezviratidzo
Musoro wemusoro MuCPS
Kazhinji tension mhando misoro
Bata sezvaunoda nekuda kwekurwadziwa musoro musoro
Deredza kudzvinyirira
Kuvandudza unyanzvi hwekubata mupfungwa
MSK kurapwa kwemishonga yemukati nematare
Constitutional hydrotherapy
Adrenal kutsigira / adaptogenic herbs
Inogona kuchinja, kunyanya kune vanhu vakanga vagara vasati vambovapo migraine vasati vakuvara
Deredza kuderedza mutoro
Funga nezvekugadzirisa nekuwedzera uye nemishonga
Deredza chiedza uye kuratidzwa kwakanaka kana kune kunzwisisika
Dhimoni MuPCS
Mushure mokunge mutambudzi wepamusoro, nguva dzose muongorore BPPV, sezvo ichi ndicho chinonyanya kurudzika chettigo mushure mekutsvaga
Dix-Hallpike inoita kuti iongorore
Epley's maneuver yekurapa
Chiedza & Ruzha Kunzwisisa
Hypersensitivity kujekesa uye inzwi rinowanzoonekwa muPCS uye zvinowanzokonzera zvimwe zviratidzo zvakadai sepfungwa uye kuzvidya mwoyo
Kutungamira kwekuwedzerwa mesencephalon kukurudzira kunokosha mumatambudziko akadaro
Sunglasses
Mamwe magirazi anovhara magirazi
Zvinyorwa
Cotton munzeve
Kurapa KwaPCS
Shandisa chiratidzo chimwe nechimwe sezvaunenge uchida
Shandisa CNS kuvhiringidzika
Curcumin
Boswelia
Mafuta ehove / Omega-3s (*** mushure me r / o kubuda ropa)
Kuchengetedza maitiro therapy
Kungwarira & zororo kudzidziswa
Acupuncture
Ubongo huchinyatsogadzirisa muviri utano hwekuita
Taura nezvekuongorora kwepfungwa / kurapwa
Taura kune mTBI nyanzvi
mTBI Nyanzvi
mTBI yakaoma kurapa uye ihwo humwe hutano huri mune allopathic uye mishonga inobatanidza
Chinangwa chekutanga ndechekucherechedza uye kutarisa kutarisirwa kwakakodzera
Tsvakai kudzidziswa muMTBI kana kuronga kutaura kune vanyori veTCTI
Sources
HeadMusoro weRamangwana. DVBIC, 4 Kubvumbi 2017, dvbic.dcoe.mil/aheadforthefuture.
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
�Tinotungamira kune Vanopa Hutano.� Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Feb. 2015, www.cdc.gov/headsup/providers/.
�Post-Concussion Syndrome.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 July 2017, www.mayoclinic.org/diseases-conditions/post- concussion-syndrome/symptoms-causes/syc-20353352.
by Dr Alex Jimenez chisingaperi Pain , Clinical Neurology , Kutemwa nemusoro nekurapwa , Migraine , Migraines , Mishonga
Origin: Chikonzero chakanyanya kuita migraines / musoro bvisa musoro . Ruzhinji rwemhando idzi rwemusoro dzinowanzoita sechisimba pakati pemakumbo emapfudzi, izvo zvinokonzera mutsara pamusoro pemapfudzi kuomesa uye kuisa marwadzo mumusoro.
Kubva Kwekurwa Kwemusoro
Inomuka kubva mumarwadzo akaoma maziso mumusoro
Zviduku zvakakura mashizha (kurwadziwa / temp) zvisina kunaka
Meninges
Tsinga
Zvinyorwa zvekuwedzera
TMJ
Eyes
Sinuses
Neck muscles uye ligaments
Dental structures
Uropi hauna hutambudzo hwemapurisa
Mharapara Trigeminal Nucleus
Trigeminal nerve
Nhengo dzemaziso
Glossopharyngeal nerve
Vagus nerve
C2 nerve (Greater occipital nerve)
Occipital Nerves
dailymedfact.com/neck-anatomy-the-suboccipital-triangle/
Sensitization Of Nociceptors
Mhinduro muAllodynia uye hyperalgesia
slideplayer.com/9003592/27/images/4/Mechanisms+associated+with+peripheral+sensitization+ to+pain.jpg
Headache Types
Mutadzi:
Meningeal irritation Intracranial masonda emasi Vascular headaches Cervical fracture or malformation Metabolic Glaucoma
Benign:
Migraine Cluster headaches Neuralgias Kurwisana musoro Secondary headaches Post-traumatic / post-concussion "Analgesic rebound" musoro Psychiatric
HA Kubva Kuchengeta Zvipembenene
Sinuses (utachiona, tumarara) Cervical spine chirwere Matambudziko emeno Temporomandibular joint Utachiona hutachiona, nezvimwewo. Ziso (glaucoma, uveitis) Extracranial arteries Nerve zilonda
HA Red Red Flags
Sirasi yemavhogi mutsvuku uye funga nezveHA dzenjodzi kana dziripo
Zviratidzo zvemuitiro:
Kuonda
Njodzi dzinomutsa kuti varare
chimhepo
Zviratidzo zveeurologic kana zviratidzo zvisingaiti:
Kungoerekana kwaitika kana kuputika
Zvitsva kana zvinokurudzira HA zvakanyanya kunyanya kuvarwere vakura
HA kurwadziwa kunogara kuri munzvimbo imwe chete
Pakave musoro wepashure
Iyi ndiyo yekutanga HA yawakambove nayo here?
Secondary risk factors:
Nhoroondo yekenza, immunocompromised, etc.
Dangerous / Sinister Headaches
Meningeal irritation
Subarachnoid homorrhage
Meningitis uye meningoencephalitis
Kuchengetedza masizi makuru
Neoplasms
Intracerebral hemorrhage
Subdural kana epidural hemorrhage
Kusuruvara
Acute hydrocephalus
Vascular headaches
Temporal arteritis
Hypertensive encephalopathy (semuenzaniso, yakaipa youtachiona, pheochromocytoma)
Arteriovenous malformations uye kuwedzera kusimba
Lupus cerebritis
Venous sinus thrombosis
Cervical fracture or malformation
Kuputsika kana kuparadzaniswa
Occipital neuralgia
Vertebral artery dissection
Chiari malformation
Metabolic
Hypoglycemia
Hypercapnea
Carbon monoxide
Anoxia
Anemia
Vitamini A chepfu
Glaucoma
Subarachnoid Hemorrhage
Kazhinji nekuda kwekuputsika aneurysm Nenguva isipi inotanga kurwadziwa kukuru Kazhinji kurutsa Murwere anorwara Kazhinji nuchal rigidity Taura nezveCCT uye zvichida kuvhara
Meningitis
Murwere anorwara chimhepo Nuchal rigidity (kunze kwevakwegura nevana vaduku) Tsvaga kuvharwa kwechiremba - kuongorora
Neoplasms
Zvisingabviri chikonzero cheHai muhuwandu hwevarwere varwere
Urombo uye hutsinye hunorwadza musoro
Zvakaipisisa mangwanani
Ingave inokurudzirwa nesimba rakaoma musoro kuzununguka
Kana zviratidzo zvakanyanya, zvirwere, zviratidzo zvepfungwa neurologic, kana uchapupu hwekuwedzera kusagadzikana kushandiswa kwezviripo mutemo wedu neoplasm
Subdural Or Epidural Hemorrhage
Nokuda kwehutachiona hwepamusoro, kushungurudzika kana kukanganisa mukubatana
Kazhinji kazhinji inowanikwa mumamiriro ekutambudzika kwemazwi makuru
Kuwedzerwa kwezviratidzo kunogona kuva vhiki kana mwedzi mushure mekukuvara
Kusiyanisa kubva kune imwechete mushure-kugadzikana musoro musoro
Post-Concussive HA inogona kupfuurira kwemavhiki kana mwedzi mushure mekukuvadzwa uye inofambidzana nechezzinesi kana vertigo uye kuchinja kwepfungwa, izvo zvese zvichapera
Kuwedzera Kuita Kuda Kufurirwa
Papilledema Inogona kukonzera kuona maonero
openi.nlm.nih.gov/detailedresult.php?img=2859586_AIAN-13-37- g001&query=papilledema&it=xg&req=4&npos=2
Nguva (Giant-Cell) Arteritis
> 50 makore Polymyalgia rheumatic Malaise Kuwedzera kwekubatana kurwadziwa Myalgia Nonspecific musoro wemusoro Unyoro hwakanyanya uye / kana kuzvirumbidza pamusoro pemasero ezuva kana occipital Uchapupu hwekusagadzikana kwemasimba mukupararira kwematazi emidziyo yemagetsi High ESR
Cervical Region HA
Neck trauma kana nezviratidzo kana zviratidzo zvemuviri wekervical kana cord compression Raira MR kana CT kambani kudzvinyirira nekuda kwekuputsika kana kuparadzaniswa Cervical instability Raira cervical spine x-rays lateral kuruka uye kuwedzerwa maonero
Kutonga Hangozi HA
Kutonga nhoroondo yedu yekuremara musoro kana kuputsika kwemutsipa, kukanganisa kana kuisa pfungwa dzehutano hwehutano, uye hutachiona hunogona kutotangira ku meningitis kana kubatwa kweuropi Tarisa fever Edza BP (hanya kana diastolic> 120) Ophthalmoscopic test Chengetedza mutsipa kuti usimbise Auscultate for cranial bruit. Kuzadza kwehutano hwehutano Kana zvichidiwa urongwa hwakazadza nhamba yezivi yeropa, ESR, hupombwe kana chiberekiti chekufungidzira
Episodic Kana Isingaperi Here?
<Mazuva gumi nemashanu pamwedzi = Episodic
> Mazuva gumi nemashanu pamwedzi = Chisingaperi
Migraine HA
Kazhinji nekuda kwekuwedzera kana kushandiswa kwechiremba vasculature
Serotonin MuMigraine
AKA 5-hydroxytryptamine (5-HT) Serotonin inopera mumagraine episodes IV 5-HT inogona kumira kana kuderedza kusuruvara
Migraine NaAura
Nhoroondo yekuti zvisungo zve 2 zvinokonzera zvinotevera
Chimwe chezvinotevera zviratidzo zverara zvakazara:
zvekuona nemeso
Somatic sensory
Kutaura kana mutauro kunonetsa
motokari
Brain stem
2 yezvinhu zvinotevera zve4:
1 aura chiratidzo chinopararira zvishoma nezvishoma pamusoro pe5 min, uye / kana 2 zviratidzo zvinoitika zvichiteerana
Chimwe nechiratidzo chema aura chinopedza 5-60 min
1 kanara chiratidzo chisina kubatana
Aura yakaperekedzwa kana kuteedzerwa mu <60 min nemusoro
Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongororwa, uye TIA haina kubviswa
Migraine Pasina Aura
Nhoroondo yekuti zvisungo zve 5 zvinokwana zvinotevera:
Kushungurudzwa kwepfungwa kunogara kwenguva refu 4-72 h (isina kupomerwa kana kuti isina kubudirira)
Unilateral kurwadziwa
Kuchengetedza / kuvhara unhu
Zvichienzanisa nekurwadziwa kukuru zvakasimba
Kushungurudzika kana kuita kuti usadzivirire kuita zvepabonde nguva dzose
Munguva yepfungwa misungo uye / kana kushushikana kune chiedza uye inzwi
Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongorora
Cluster Headache
Yakakura unilateral orbital, supraorbital uye / kana kurwadziwa kwepanguva
"Senge chando chando chinondibaya ziso"
Pain inotora 15-180 maminitsi
Pane chimwe chezvinhu zvinotevera kune rumwe rutivi rwemusoro:
Conjunctival injection
Facial sweating
Kurambidzwa
Miosis
Nasal kusanganiswa
Ptosis
Rhinorrhea
Eyelid edema
Nhoroondo yemakumbo akafanana munguva yakapfuura
Kupopotedzana musoro
Kutambudzika kwepfungwa kunofambidzana nezviviri zvinotevera:
Kuomesa / kusimbisa (kusinga-kutakurira)
`` Anonzwa kunge bhanhire rakatenderedza musoro wangu ''
Nharaunda
Haisi kukurudzirwa nekuita mabasa ose
Musoro unofanirwa kushayikwa:
Nausea kana kurutsa
Photophobia uye phonophobia (imwe kana imwe inogona kuvapo)
Nhoroondo yemakumbo akafanana munguva yakapfuura
Kudzokorora Musoro
Musoro unoitika pamazuva gumi nemashanu mumwedzi murwere ane chirwere chepfungwa chisati chavapo
Kugara uchishandiswa zvakanyanya kwe> 3 mwedzi yemumwe kana anopfuura madhiragi anogona kutorwa zvakanyanya uye / kana chiratidzo chekurapa kwemusoro
Pamusana pemishonga yekurapa / kubvisa
Kwete zviri nani zvakataurwa nomumwe ICHD-3 kuongorora
Sources
Alexander G. Reeves, A. & Swenson, R. Kukanganiswa kweNervous System. Dartmouth, 2004.
Share Free Ebook
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
en.wikipedia.org/wiki/Cortical_homunculus
Chechi, Archibald. Kutya uye Kuora Mwoyo. WB Saunders Co., 1923.
Ndozi Inoshandiswa EMG
MUPS yePolphasitiki
Complete Potential Blocks
Positive Sharp Waves
Abnormal Findings
