Lub Tebchaws Ophthalmoplegia

Zoo Siab

• Txheej txheem cej luam
• Dab tsi yog muaj ntau hom?
• Cov tsos mob zoo li cas?
• Dab tsi ua?
• Nws kuaj tau li cas?
• Cov kev kho mob xaiv
• Qhov tshwm sim yog dab tsi?

Txheej txheem cej luam

Internuclear ophthalmoplegia (INO) yog qhov tsis muaj peev xwm txav ob lub qhov muag ua ke thaum saib mus rau sab. Nws tuaj yeem cuam tshuam tsuas yog ib qho muag, lossis ob lub qhov muag xwb.

Thaum saib mus rau sab laug, koj sab xis yuav tsis tig deb npaum li nws yuav tsum tau. Lossis thaum saib mus rau sab xis, koj sab laug lub qhov muag yuav tsis tig los puv. Tus mob no txawv ntawm qhov muag hla (strabismus), uas tshwm sim thaum koj tab tom saib ncaj rau tom ntej lossis mus rau sab.

Nrog INO, koj kuj tseem tuaj yeem pom ob lub zeem muag (daim ntawv pov thawj dhau los) thiab muaj lub suab nrawm dua (nystagmus) hauv qhov muag cuam tshuam.

INO tshwm sim los ntawm kev puas tsuaj rau medial longitudinal fasciculus, ib pawg ntawm cov hlab hlwb ua rau lub hlwb. Nws pom muaj rau cov laus thiab cov laus. INO nyob hauv menyuam yaus.

Dab tsi yog muaj ntau hom?

INO tau faib ua peb yam loj:

• Neeg Tsis Sib Koom. Tus mob no cuam tshuam tsuas yog ib qho muag.
• Ob Leeg. Tus mob no cuam tshuam ob lub qhov muag
• Phab ntsa-eyed ob sab sib luag (WEBINO). Daim ntawv hnyav no, ob sab qauv ntawm INO tshwm sim thaum ob lub qhov muag tig sab nraud.

Keeb kwm, cov kws tshaj lij kuj tau cais tawm INO rau hauv qib siab (pem hauv ntej) thiab tom qab (rov qab) ntau yam. Nws tau xav tias qee qhov tsos mob tuaj yeem qhia qhov twg hauv lub hlwb cov hlab ntaws tau nyob. Tab sis qhov system no tau ua qis dua. MRI scans tau pom tias qhov kev faib tawm tsis tuaj yeem ntseeg tau.

Cov tsos mob zoo li cas?

Cov tsos mob tseem ceeb ntawm INO tsis tuaj yeem txav koj qhov muag cuam tshuam rau koj lub qhov ntswg thaum koj xav saib mus rau sab nraud.

Lo lus siv rau kev kho mob rau qhov txav ntawm lub qhov muag mus rau lub taub ntswg yog "adduction." Koj tuaj yeem hnov ​​tus kws kho mob tshwj xeeb tau hais tias koj muaj qhov tsis hnov ​​lus ntawm lub qhov muag adducting.

Qhov ob qhov tsos mob tseem ceeb ntawm INO yog koj lub qhov muag, hu ua "qhov muag tshem tawm," yuav muaj qhov rov qab tso thiab rov qab mus los. Qhov no hu ua “nystagmus.” Qhov kev txav no tsuas kav ntev li ob peb zaug, tab sis nws tuaj yeem ua rau hnyav dua. Nystagmus tshwm sim hauv 90 feem pua ​​ntawm cov neeg muaj INO.

Txawm hais tias koj lub qhov muag tsis tau txav ua ke, koj kuj tseem tuaj yeem tsom pom ob lub qhov muag ntawm qhov khoom uas koj tab tom saib.

Qee lwm cov tsos mob tshwm sim ntawm INO suav nrog:

• qhov muag plooj
• pom ob npaug (diplopia)
• kiv taub hau
• pom cov duab ob, ib qho nyob rau sab saum toj ntawm lwm tus (ntsug kev cai lij choj)

Hauv qee qhov mob me, koj yuav hnov ​​cov tsos mob li ib ntus. Thaum lub qhov muag adducting cuam nrog nrog lwm lub qhov muag, koj lub zeem muag hloov zuj zus.

Kwv yees li ib nrab ntawm cov neeg uas muaj INO yuav pom tsuas yog cov tsos mob me no.

Hauv ntau qhov xwm txheej loj dua, lub qhov muag adducting tsuas yog yuav tsuas tig tau ib feem ntawm txoj kev mus rau lub qhov ntswg.

Hauv cov xwm txheej huab, qhov cuam tshuam qhov muag tsuas yog mus txog ntawm kab nruab nrab. Qhov ntawd txhais tau tias koj lub qhov muag yuav cuam tshuam pom tom hauv ntej, thaum koj sim ntsia mus rau sab tag nrho.

Dab tsi ua?

INO yog qhov tshwm sim ntawm kev puas tsuaj rau medial longitudinal fasciculus. Qhov no yog cov hlab ntsha ua rau lub hlwb ua.

Qhov kev puas tsuaj tuaj yeem yog vim ntau yam ua.

Txog ntawm kis yog los ntawm tus cwj nrag thiab lwm yam mob uas thaiv cov ntshav mus rau lub hlwb.

A stroke tuaj yeem raug hu ua ischemia, lossis kev siv ischemic nres. Kev mob stroke cuam tshuam rau cov neeg laus, thiab cuam tshuam tsuas yog ib lub qhov muag. Tab sis kev mob stroke cuam tshuam rau ib sab ntawm lub hlwb qee zaum ua rau INO ntawm ob lub qhov muag.

Txog lwm ntawm kis tau los ntawm ntau tus mob sclerosis (MS). Hauv MS, INO feem ntau cuam tshuam ob lub qhov muag. IN-MS-tshwm sim INO yog nyob rau cov hluas thiab cov neeg laus hluas.

Nco ntsoov tias MS yog ib qho kev piav qhia ntawm kev mob, tsis yog ua rau. Hauv cov mob no, lub cev tiv thaiv tawm tsam cov myelin sheath uas nyob ib puag ncig thiab lub zog ntawm cov hlab ntsha. Qhov no tuaj yeem ua rau raug mob rau hauv lub hnab riam thiab ntawm cov leeg paj xov uas nws ncig.

Nrog INO, nws tsis tshua paub qhov ua dab tsi ua rau kev puas tsuaj rau myelin sheath, hu ua "demyelination." Ntau yam mob, nrog rau tus mob Lyme, tau cuam tshuam nrog nws.

Lwm yam mob uas tuaj yeem ua rau INO suav nrog:

• mob hlwb o
• Behcet's disease, yog ib qho mob uas tsis tshua muaj mob uas ua rau cov hlab ntshav txhaws
• cryptococcosis, yog ib tug kab mob fungal txuam nrog AIDS
• Guillain-Barré mob
• Lyme mob thiab lwm yam mob zuam
• lupus (cov kab mob lupus erythematosus)
• taub hau
• hlav hlwb

Cov hlav xws li pontine gliomas lossis medulloblastomas yog qhov tseem ceeb ua rau INO rau menyuam yaus.

Nws kuaj tau li cas?

Koj tus kws kho mob yuav coj keeb kwm kab mob kev nkeeg thiab kuaj mob ntawm koj lub qhov muag. Cov cim ntawm INO tuaj yeem paub meej tias yuav tsum tau kuaj me ntsis kom paub meej tias kuaj mob.

Koj tus kws kho mob yuav hais kom koj mob siab rau lawv lub qhov ntswg, thiab tom qab ntawd maj mam ntsia koj lub ntsej muag rau tus ntiv tes uas nyob sab. Yog tias lub qhov muag saib xyuas thaum tig mus rau sab, nws yog qhov cim ntawm INO.

Koj tseem yuav raug sim rau qhov rov qab-thiab-dhau qhov txav ntawm qhov muag tshem tawm (nystagmus).

Thaum kuaj tau pom lawm, koj tus kws kho mob yuav ua qhov kev ntsuas ntsuas kom pom qhov chaw puas tsuaj qhov twg. Kev txiav txim MRI thiab tej zaum yuav muaj qhov CT scan yuav xaj.

Txog ntawm cov neeg muaj feem ntau yuav pom qee qhov kev pom kev puas tsuaj rau qhov ntev ntev ntawm qhov muag loj nyob ntawm MRI scan.

Cov duab tiv thaiv tiv thaiv-tuab ua qhov hnyav kuj tseem siv tau.

Cov kev kho mob xaiv

INO tuaj yeem yog cov cim ntawm cov mob hnyav uas yuav tsum tau kho. Yog koj mob stroke qis, yuav tsum tau pw hauv tsev kho mob. Lwm yam mob xws li MS, kab mob kis thiab lupus yuav tsum tau tswj hwm los ntawm koj tus kws kho mob.

Thaum qhov ua kom muaj mob ntawm tus mob ophthalmoplegia yog tus mob MS, tus kab mob, lossis kev raug mob, tib neeg ua kom pom kev zoo rov los.

Kev kho kom puv yog tias qhov ua rau mob stroke lossis lwm qhov teeb meem cerebrovascular. Tab sis tag nrho cov nyiaj rov qab yog tias INO tsuas yog tus mob neurological xwb.

Yog tias ob lub zeem muag (daim ntawv pov thawj (diplopia) yog ib qho ntawm koj cov tsos mob, koj tus kws kho mob yuav xav kom txhaj tshuaj botulinum toxin txhaj, lossis Fresnel prism). Tus Fresnel prism yog cov yas ua yeeb yaj kiab nyias uas txuas rau sab nraub qaum ntawm koj lub tsom iav kom kho ob lub zeem muag.

Yog tias muaj qhov txawv txav uas hu ua WEBINO, kev kho qhov mob niaj zaus siv rau strabismus (hla lub qhov muag) yuav raug siv.

Kev kho mob tshiab ntawm tes yog muaj los kho demyelination, xws li los ntawm MS lossis lwm yam.

Qhov tshwm sim yog dab tsi?

INO tuaj yeem kuaj tau los ntawm kev soj ntsuam lub cev yooj yim. Qhov txiaj ntsig yog qhov zoo rau feem ntau. Nws yog ib qho tseem ceeb kom pom koj tus kws kho mob thiab cov cai tawm, lossis kho, qhov ua tseem ceeb.