Myasthenia Gravis, Lambert-Eaton, da Botulism
Yayin da aka yi la'akari da dalilin rashin rauni, yana da taimako wajen tunanin sakonnin lantarki daga harkar kwakwalwar kwakwalwa har zuwa muscle kwangila. A hanya, motsin ya motsa ta cikin cikin kashin baya a cikin ƙaho na baya , fitar da asalinsu na jijiyoyin ƙwayoyi, saukar da jijiyoyi na jiki , kuma daga karshe zuwa jigon neuromuscular.
Yanayin neuromuscular shine inda siginar lantarki ya haifar da suturar da za a fitar da su daga vesicles a ƙarshen jijiya.
Masu ba da yaduwa sun haɗu da ƙananan rata a tsakanin iyakar ƙwayar jiki ( daɗin jiki ) da kuma farfajiya (tsofaffin). Tsayawa ga masu watsawa a gefe ɗaya na rata su ne masu karɓa na musamman wanda ya dace da mai watsawa kamar ƙulle zuwa maɓalli. Lokacin da akwai fitarwa, zubar da ions zai haifar da rikitarwa na muscular.
Neurotransmitter da aka yi amfani da ita don sigina tsakanin jijiya da tsoka ne acetylcholine. Akwai hanyoyi da dama da wannan katsewar na neurotransmitter acetylcholine tsakanin jijiya da tsoka CTan za a katse. Uku daga cikin misalan mafi kyawun su ne myasthenia gravis , cututtukan Lambert-Eaton, da kuma cututtukan botulinum.
Myasthenia Gravis
Tare da yaduwa tsakanin mutane 150 zuwa 200 a kowace miliyoyin, myasthenia gravis shine mafi yawan kwayoyin neuromuscular, kuma daya daga cikin mafi kyaun fahimtar dukan cututtukan da ke cikin jiki. Sakamakon cutar yana haifar da rauni ta tsoka saboda masu karɓa na neurotransmitter a kan tsoka.
Kwayoyin rigakafi da ake nufi don kai hari ga kuskuren kuskure suna kuskuren masu karɓa na acetylcholine don fasikanci da kai hari. Harkokin motsa jiki na tayar da hankali don yin rauni. Daga tsakanin 60 zuwa 70 bisa dari na mutanen da ke dauke da myasthenia gravis suna da matsala tare da thymus , kuma kashi 10 zuwa 12 cikin dari yana da maganin ka. Akwai wasu magunguna daban-daban.
Lambert-Eaton Myasthenic Syndrome (LEMS)
Lambert-Eaton shine sau da yawa abin da ake kira wani ciwo na paraneoplastic , ma'ana cewa kwayoyin da ke da alaka da ciwon daji suna kai hare-haren ɓangare na tsarin jin tsoro. Ba kamar ƙwararren myasthenia, wanda tsarin da aka kai hari kan tsoka ba, matsala a LEMS yana tare da ƙarshen motar motar. Kwayoyin Calcium kullum suna budewa da sigina don sakin masu ba da agaji, amma ba za su iya yin hakan a LEMS ba saboda ciwon daji sun kai hari ga tashar. Sakamakon haka, babu sakonnin neurotransmitter, kuma masu haƙuri suna fama da rauni saboda tsoka ba zai iya karɓar sigina don kwangila ba. Tare da aikace-aikace na yau da kullum, za a iya cin zarafi. don haka a LEMS, alamun cututtuka wasu lokuta sukan inganta tare da kokarin da suke ci gaba.
Botulism
Kwayar Botulinum wasu lokuta wasu likitoci sun yi amfani da niyya don tilasta tsokoki su shakata a lokuta na dystonia . A cikin nauyin kwayar cutar, kwayar cutar ta haifar da kwayoyin cuta kuma zai iya haifar da nakasa wanda zai fara tare da tsokoki na fuska da wuya kuma sauka a kan sauran jikin. Kamar sauran tashe-tashen hankulan ƙananan neuromuscular, wannan zai iya zama gaggawa gaggawa da ake buƙatar intubation . Wadannan sunadarin sunadarin sunadarai da ke bada izinin jigilar ƙwayoyin da ke cike da ƙwayoyin neurotransmitters a cikin neuron farko na synaptic don tsutsawa a ƙarshen jiji kafin zubewa a cikin sarari tsakanin jijiya da tsoka.
Jiyya ne maganin maganin botulinum, wanda ya kamata a ba shi da wuri-wuri.
Sauran Cutar Neuromuscular Junction
Wasu magungunan, irin su penicillamine da wasu statins, zai iya haifar da wani abu mai mahimmanci wanda ya yi amfani da myathenia gravis. Yawancin magunguna masu yawa na iya damuwa ko kuma kawo rikici a cikin wanda ya riga ya sami mahimmanci na myasthenia.
Jaraba ga Cututtuka na Yankin Neuromuscular Junction
Bayan nazarin jiki, mataki na farko da ke bincikar cutar da ƙananan neuromuscular shine ilimin electromyogram da nazarin haɓaka. Wadannan ba zasu iya taimakawa wajen rarrabe bambanci tsakanin myasthenia gravis, poisonulin botulinum, da Lambert-Eaton amma zai iya taimakawa wajen fitar da wasu cututtuka irin su mota neuron, ciki har da amyotrophic laral sclerosis.
Rashin lafiya na jigilar neuromuscular zai iya zama mai tsanani, yana buƙatar intubation da iska don taimakawa numfashi idan rauni ya zama mai tsanani sosai. Hanyoyin irin wannan cuta sun bambanta, suna buƙatar daban-daban jiyya. Sakamakon ganewa daidai shine mataki na farko da ya sake samun ƙarfi da aminci.
Sources:
Ropper AH, Samuels MA. Ka'idodi na Adams da Victor na Lafiya, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Hal Blumenfeld, Neuroanatomy ta hanyar Cutar Clinical. Sunderland: Sinauer Associates Publishers 2002.