Lefu la Osmotic demyelination

Osmotic demyelination syndrome (ODS) ke ho se sebetse ha lisele tsa boko. E bakoa ke ho senngoa ha lera (myelin sheath) le koahelang lisele tsa methapo bohareng ba brainstem (pons).

Ha shehe ea myelin e koahelang lisele tsa methapo e senyeha, lipontšo tse tsoang ho methapo e meng ha li fetisoe hantle. Leha brainstem e amehile haholo, likarolo tse ling tsa boko le tsona li ka ameha.

Lebaka le tloaelehileng haholo la ODS ke phetoho e potlakileng maemong a 'mele ea sodium. Hangata hona ho etsahala ha motho a fuoa kalafo ea sodium e tlase ea mali (hyponatremia) mme sodium e nkeloa sebaka kapele haholo. Ka linako tse ling, e etsahala ha boemo bo phahameng ba sodium 'meleng (hypernatremia) bo lokisoa kapele haholo.

Hangata ODS ha e itlhahele feela. Hangata, ke bothata ba kalafo bakeng sa mathata a mang, kapa ho tsoa mathateng a mang ka bo ona.

Likotsi li kenyelletsa:

• Tšebeliso ea joala
• Lefu la sebete
• Khaello ea phepo e nepahetseng e tsoang mafung a tebileng
• Kalafo ea mahlaseli a boko
• Ho nyekeloa ke pelo le ho hlatsa nakong ea bokhachane

Matšoao a ka kenyelletsa efe kapa efe ea tse latelang:

• Pherekano, pherekano, lipono
• Mathata a ho leka-lekana, ho thothomela
• Bothata ba ho koenya
• Ho fokotsa ho fadimeha, ho otsela kapa ho otsela, ho tepella, ho arabela hampe
• Puo e sa hlakang
• Bofokoli sefahlehong, matsohong kapa maotong, hangata bo ama mahlakore ka bobeli a 'mele

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse ka matšoao.

Tlhatlhobo ea hlooho ea MRI e ka senola bothata bokong (pons) kapa likarolong tse ling tsa boko. Ena ke eona teko ea mantlha ea ho hlahloba.

Liteko tse ling li ka kenyelletsa:

• Tekanyo ea sodium ea mali le liteko tse ling tsa mali
• Karabelo ea kelello e hlahisitsoeng ke Brainstem (BAER)

ODS ke bothata ba tšohanyetso bo hlokang ho phekoloa sepetlele leha batho ba bangata ba nang le boemo bona ba se ba le sepetlele bakeng sa bothata bo bong.

Ha ho na pheko e tsebahalang bakeng sa pontine myelinolysis. Kalafo e shebane le ho imolla matšoao.

Phekolo ea 'mele e ka thusa ho boloka matla a mesifa, ho sisinyeha le ho sebetsa matsohong le maotong a fokolang.

Tšenyo ea methapo e bakoang ke pontine myelinolysis e bohareng hangata e nka nako e telele. Boloetse bona bo ka baka bokooa bo tebileng ba nako e telele (bo sa foleng).

Mathata a ka kenyelletsa:

• Ho fokotsa bokhoni ba ho sebelisana le ba bang
• Ho fokotsa bokhoni ba ho sebetsa kapa ho itlhokomela
• Ho sitoa ho sisinyeha, ntle le ho panya mahlo (syndrome "not in")
• Tšenyo e sa feleng ea sistimi ea methapo

Ha ho na tataiso ea 'nete ea hore na u ka ea ngakeng neng, hobane ODS ha e fumanehe sechabeng ka kakaretso.

Sepetlele, kalafo e liehang le e laoloang ea boemo bo tlase ba sodium e ka fokotsa kotsi ea tšenyo ea methapo liponong.Ho tseba ka moo meriana e meng e ka fetolang maemo a sodium ho ka thibela boemo hore bo fetohe kapele haholo.

ODS; Ho tlosa demiline bohareng

• Sisteme ea methapo e bohareng le methapo ea methapo

Weissenborn K, Lockwood AH. Encephalopathies e chefo le ea metabolism. Ka: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, bahlophisi. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 84.

Yaqoob MM, McCafferty K. Balanse ea metsi, maro le li-electrolyte. Ho: Masiba A, Randall D, Waterhouse M, eds. Bongaka ba Bongaka ba Kumar le Clarke. 10th ed. Philadelphia, PA: Elsevier; 2021: khaolo ea 9.