Miller-Fisher syndrome: cov tsos mob, kev kho mob, lub neej expectancy

Ib yam ntawm tsawg Guillain-Barre syndrome, uas yog ib ceg ntawm ib tug ntshiab daim duab nyob rau hauv lub cev ntawm tus neeg mob dab yog tus Miller-Fisher syndrome. Nws yog yus muaj los ntawm ib tug triad ntawm cov tsos mob uas manifest lawv tus kheej sib npaug nyob rau hauv tag nrho cov neeg.

txhais

Guillain-Barre syndrome yog ib tug tsis tshua tshwm sim. Nyob rau hauv kev kho mob xyaum, nws cov nuj nqis yog rau 1-2 cov neeg ib puas txhiab pejxeem. Nws zoo nkaus li ntau nyob rau hauv cov txiv neej thiab muaj ob tug peaks ntawm nws cov kev ua si:

• hluas muaj hnub nyoog - 20-24 xyoo;
• qub - 70-74 xyoo.

Nws yog zoo dua lub npe hu neurologists thiab muaj ib tug xov tooj ntawm txawv nta, tus me nyuam ntawm analyses confirmative hlwb txha nqaj qaum kua. Dhau li classical ndlwg ntawm cov kab mob, nws yog pom Miller Fisher syndrome, piav no American neurologist rov qab nyob rau hauv 1956 xyoo.

cov tsos mob

Tus kab mob yog tsis tshua muaj tsis tshua muaj thiab yog hais txog ib tug mob inflammatory kab mob autoimmune uas muaj feem xyuam rau cov myelin paj sheath. Thaum pib thiab nyob rau hauv lub ntxiv kev loj hlob ntawm Miller-Fisher syndrome yeej ib txwm tshwm sim tib yam thiab muaj cov nram qab series ntawm cov yam ntxwv cov tsos mob nws

• arefleksiya - yog ib tug ceev extinction, thiab nws thiaj li tag tsis tuaj kawm ntawv ntawm nqua reflexes;
• ataxia - cerebellar mob cim;
• ophthalmoplegia - tuag tes tuag taw ntawm lub qhov muag nqaij, feem ntau lwm, thiab nyob rau hauv txoj tus neeg mob thiab domestic;
• tarapez thiab tuag tes tuag taw ntawm ua pa nqaij - tsim mus rau hauv loj heev, tshaj tus neeg mob.

Nrog cov kev txiav txim ntawm cov tsos mob thiab raws sij hawm pib ntawm kev kho mob, tus kab mob no yog benign, nws tsis ua rau muaj teeb meem thiab feem ntau xaus nrog txawj rov qab.

yog vim li cas

Nrog raws sij hawm kev kho mob rau cov kws kho mob rau ib tug ob peb lub lis piam los yog lub hlis, koj muaj peev xwm kho tau tus Miller-Fisher syndrome. Mus txog yuav ua li cas muaj ntau yam nyob nrog xws li ib tug kab mob, cia li tsis xam tawm li cas tsis meej thiab nws ua. Tab sis rau cov neeg feem coob nrog no mob tshwj xeeb cog lus tias feem ntau dej siab forecasts. Tag nrho rov qab los ntawm tag nrho cov kev khiav dej num nyob rau hauv lub cev nyob rau hauv qhov tseeb thiab tsim nyog kho mob, yuav siv sij hawm ib tug tshaj plaws ntawm kaum lub lis piam. Thiab tsuas ib tug me me muaj pes tsawg tus ntawm cov neeg mob nrog advanced mob yuav tsum tau ib tug xov tooj ntawm ntxiv noj qab haus huv ntsuas.

Ib feem ntawm cov kev kho mob ua hauj lwm hais tias feem ntau qhov ua rau ntawm tus kab mob no yog ua ib qho tshuaj tiv thaiv. Nyob rau hauv tej rooj plaub, nws twb ntes tau tom qab ib qho nyuaj kis tus kab mob cov kab mob, cov tsos mob tej zaum manifested tom qab heev kev kho mob ntawm ob peb txoj kab mob. Paub tsev neeg keeb kwm ntawm tus kab mob, tawm tswv yim ib tug kev tshuaj ntsuam genetic predisposition mus tus kab mob no rau hauv lub cev.

soj ntsuam cov qhab nia

Ua ntawv tsis txaus siab muaj rau tus neeg mob, feem ntau qhia nyob rau hauv cov nram no sib nrauj:

• tsis muaj zog, tsis muaj zog, tsis muaj zog, kiv taub hau;
• nyuaj zom, thiab ib tug me ntsis rau yav tom ntej, nrog ib tug hais lus;
• teeb meem nyob rau taug kev, thiab nws tus kheej-kev pab cuam;
• Nquag xws li loog loog ntawm ob txhais tes thiab ob txhais taw, yoj zoo li mob nyob rau hauv lub nqua.

Hais tias downward tuag tes tuag taw - ib tug ua txhaum ntawm lub qhov muag zog, thiab ntxiv thiab lwm yam extremities (koj lub xub ntiag ntawm cov hnab looj tes rau hauv koj txhais tes) yog qhia lub Miller-Fisher syndrome. Cov tsos mob no zoo heev rau cov Gane-Barre syndrome, tab sis qhov no hom ntawm pathology yog cai tuag tes tuag taw ntawm lub upward cim - los ntawm lub qis rau sab qaum kev ib ntawm lub cev.

Nyob rau hauv tas li ntawd mus rau lub tsis muaj zog ntawm lub qhov muag nqaij, impaired kev sib koom tes thiab ua kom tiav tsis reflexes, tus neeg mob tej zaum yuav tsum tau qhia thiab ib tug xov tooj ntawm ob tsos mob, nrog rau ib tug ntau yog mob.

• Qhov kub rhiab heev ntawm daim tawv nqaij yog npaum li cas qis.
• Tus neeg mob yog suab tsis rhiab rau qhov mob.
• Nqos qaub ncaug yuav tsis yooj yim.
• Nws yog discontinuous, unpronounceable lus.
• Gag reflex yog tsis tuaj kawm ntawv.
• Kev tsis txaus siab txog qhov zis teeb meem.

Ib feem ntawm cov tsos mob xws li nqaij tsis muaj zog thiab hais lus teeb meem yuav tshwm sim nthawv. Lawv kom meej meej qhia ib tug loj mob qhov teeb meem no thiab yuav tsum tau tam sim ntawd kev lub tswv yim.

diagnostics

Yuav kom meej qhia hais tias tus Miller-Fisher syndrome, nws yuav tsum tau nqa tawm ib tug xov tooj ntawm cov kev tshawb nrhiav.

1. Yuav Tsum chaw twg los lub neurologist, uas tshuaj xyuas thiab qhia tag nrho cov tau neurological ntshawv siab.
2. Qhia ib tug lumbar tej. Nyob rau hauv feem ntau, nws qhia muaj protein ntau indicators hais rau tus kab mob no.
3. PCR Analysis - tso cai los mus txiav txim tau exciter. Qhov no tej zaum yuav yog ib tug herpes kab mob no, Epstein-Barr virus, cytomegalovirus thiab lwm yam.
4. Feem ntau cov kws ntxiv assigns ib tug CT scan kom paub tau comorbidities neurological.
5. Rau obligatory ntshav kuaj uas qhia hauv lub xub ntiag ntawm anti-ganglioside tshuaj. Qhov no yog ib tug ntshiab qhia ntawm lub xub ntiag mob, qhov zoo tshwm sim ntawm no tsom xam yog muaj tseeb qhia txog cov mob.

Miller-Fisher syndrome yog complex thiab yuav tsum tau cov tshaj plaws yog diagnostics, thov elektroneyromirografiya, differential tsom xam, muab piv cov tsos mob nrog ib tug xov tooj uas zoo xws li cov kab mob.

txoj kev kho

Kev kho mob ntawm tus kab mob no yuav muaj txoj kev ntsuas mus suppress tiv thaiv kab mob tshua thiab ntshav clearance ntawm lub antibody. Kom txij nkawm thiab symptomatic txoj kev kho tso cai rau ib tug luv luv lub sij hawm kiag li tshem tawm cov Miller-Fisher syndrome. Kev kho mob nyob rau hauv cov kev taw qhia ntawm ib tug tej tus kws khomob tshwjxeeb ua heev zoo tau, thiab tag nrho rov qab. Nyob rau hauv tsis tshua muaj heev neeg mob (tsuas yog peb ib xees ntawm tag nrho cov) rov, tawm tswv yim ib tug ntxiv chav kawm ntawm complex txoj kev kho.

1. Kev ntsuam xyuas tus pa system, nyob rau hauv tus neeg mob qhov twg tus neeg mob yog ib qhov nyuaj rau mus rau lawv tus kheej, lub tsev kho mob yog muab ib tug mus tas kho mob saib xyuas.
2. Thaum lub sij hawm ua ntej tsib hnub (tsis pub tshaj li ob lub lis piam tom qab thawj zaug tsos mob pib) tsa los ntawm plasmapheresis thiab immunoglobulin.
3. Rau kev tiv thaiv ntawm ib tug ua tau venous thrombosis siv anticoagulants.
4. Nws yuav tsum tau tas li tswj ntawm cov ntshav siab, raws li nws ntse sib txawv yuav ua tau kom loj teeb meem.
5. Nyob rau hauv tas li ntawd, cov chav kawm nrog ib tug hais lus kws kho mob.