Lo lus "kev mob vwm" yog hais txog kab mob ntev ntawm lub hlwb, uas yog tus cwj pwm los ntawm kev tawg ntawm kev ua haujlwm ntawm nws cov hlwb. Hauv cov menyuam yaus, tus kab mob no tshwm sim ntau dua li cov neeg laus. Feem ntau, nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm convulsive qaug dab peg.
Yuav ua li cas
Nws tsis tshua muaj peev xwm txiav txim siab tias yog vim li cas tus menyuam muaj mob vwm. Tab sis qhov no tsis tau txhais hais tias tsis muaj qhov taw qhia hauv kev tshuaj xyuas cov menyuam mos. Raws li qhov ua rau muaj mob vwm hauv menyuam yaus, hom kab mob no kuj txawv.
Ntau tus hu ua lub tshuab ua haujlwm raug mob, kis kab mob. Nws kuj tau hais tias yog kab mob autoimmune. Cov qauv no tau lees paub los ntawm qhov tseeb tias autoantibodies rau neuroantigens pom nyob rau hauv cov ntshav ntawm cov neeg mob.
Hauv cov menyuam yaus, cov laj thawj hauv qab no tuaj yeem ua rau muaj tus kabmob pib.
1. Keeb kwm. Tab sis cov kws tshawb fawb hais tias nws tsis yog lawm hais tias tus kab mob vwm kis tau. Los ntawm kev qub txeeg qub teg, koj tsuas tuaj yeem tau txais ib qho kev xav rau nws.tsos. Txhua tus neeg muaj qee theem ntawm kev qaug dab peg, tab sis seb puas muaj mob vwm tshwm sim nyob ntawm ntau yam laj thawj.
2. Mob hlwb. Kev ua haujlwm tsis zoo hauv kev ua haujlwm ntawm lub hauv paus paj hlwb tshwm sim vim muaj kev cuam tshuam ntawm cov khoom tsis zoo ntawm tus menyuam hauv plab, kab mob ntawm leej niam thaum cev xeeb tub. Lawv kuj tuaj yeem tshwm sim los ntawm kev mob caj ces.
3. Cov kab mob kis tau. Tus kab mob tuaj yeem tshwm sim tom qab raug mob meningitis lossis encephalitis. Tsis tas li ntawd, tus me nyuam yau, qhov muaj feem ntau ntawm kev mob qaug dab peg yav tom ntej, lawv yuav nyuaj dua. Muaj tseeb tiag, yog tias tus me nyuam muaj qhov ua tsis taus pa siab, ces txhua yam kab mob tuaj yeem ua rau tus kab mob.
4. Kev raug mob. Txhua lub tshuab tuaj yeem ua rau qhov pib mob vwm. Tab sis kev sib raug zoo tsis yog ib txwm tsim tau, vim tias tus kab mob tsis pib tam sim ntawd.
paub paub tias dab tsi yog qhov ua rau muaj mob vwm hauv menyuam yaus, koj tuaj yeem txiav txim siab txog cov tswv yim ntawm kev kuaj thiab kho ntxiv.
Kev faib kab mob
Cov kws tshaj lij txheeb xyuas ntau hom kab mob no, nyob ntawm seb qhov ua rau muaj kev tawm tsam.
Yog tias qhov teeb meem tsim los ntawm cov txheej txheem tsis xws luag hauv lub hlwb, ces peb yuav tham txog cov tsos mob qaug dab peg. Nws tuaj yeem tshwm sim los ntawm kev tsim cov cyst, qog, lossis hemorrhage hauv lub cev. Peb tab tom tham txog idiopathic qaug dab peg nyob rau hauv cov xwm txheej uas tsis muaj qhov pom kev hloov pauv hauv lub hlwb, tab sis tus me nyuam muaj kev cuam tshuam los ntawm kev txhim kho qhov no.kab mob.
Tab sis muaj cov xwm txheej thaum cov tsos mob ntawm tus mob qaug dab peg hauv tus menyuam tau hais tawm, thiab qhov ua rau tus mob no tsim tsis tau. Hom kab mob no hu ua cryptogenic.
Tsis tas li, cov kws tshaj lij paub qhov txawv hauv cheeb tsam thiab cov kab mob dav dav. Hauv thawj kis, cov chaw ua haujlwm hauv lub hlwb raug txwv nruj. Lawv ib txwm tsim nyob rau hauv tib qhov chaw ntawm lub paj hlwb. Thiab nrog cov ntaub ntawv dav dav, yuav luag tag nrho cerebral cortex koom nrog cov txheej txheem pathological.
Cais faib cov sib xyaw ua ke. Thaum xub thawj, qaug dab peg pib raws li hauv zos, tab sis qhov ua kom pom tseeb ntawm kev zoo siab sai sai kis mus rau tag nrho cortex.
thawj hu
Txhua tus niam txiv yuav tsum paub tias dab tsi yog cov cim qhia ntawm tus mob vwm ntawm tus menyuam. Tom qab tag nrho, qhov teeb meem no tau kuaj pom hauv 3% ntawm cov menyuam yaus hnub nyoog qis dua 9 xyoos. Hauv cov menyuam mos, nws tuaj yeem tsis meej pem nrog kev ua lub cev ib txwm muaj. Tus me nyuam tig nws lub taub hau, nquag txav nws ob txhais tes thiab ob txhais ceg. Lub convulsive tivthaiv tsis yog ib txwm muaj nyob rau hauv lawv.
Kev qaug dab peg tuaj yeem tshwm sim thaum twg los tau. Tab sis feem ntau lawv tshwm sim thaum lub paj hlwb thiab paj hlwb tsis tau tag nrho matured. Nws yooj yim dua rau cov kab mob foci ntawm excitation tshwm sim hauv cov xwm txheej zoo li no.
Qee qhov qaug dab peg yuav pom tsis tau rau lwm tus. Txawm cov niam txiv kuj yuav tsis xyuam xim rau lawv. Lawv tshwm sim nyob rau hauv "hover" hais tias tsuas yog ob peb feeb xwb. Feem ntau hom kab mob hauv cov menyuam yaus yog qhov tsis tuaj yeem ua tsis taus pa (pycnolepsy). Thaum muaj kev tawm tsam, tus menyuam tsis nco qab ploj mus, kev txav rov qab tau pomtaub hau, ob lub qhov muag tuaj yeem dov. Thaum kawg ntawm kev tawm tsam, tsis siv neeg pharyngo-qhov ncauj txav feem ntau tshwm sim. Nws tuaj yeem yog di ncauj licking, smacking, nqus. Cov kev tawm tsam no feem ntau tsis pub dhau 30 vib nas this. Tab sis lawv tuaj yeem rov qab tau ntau zaus txawm tias nyob hauv ib hnub.
Cov niam txiv yuav tsum paub tias cov no yog cov tsos mob ntawm tus mob vwm ntawm tus menyuam. Kev qaug dab peg tuaj yeem tshwm sim los ntawm kev pw tsaug zog tsis zoo, txo qis lossis, qhov sib txawv, kev ua haujlwm ntawm lub paj hlwb, photostimulation.
kab mob daim ntawv
Cov kws kho mob tshwj xeeb tsis yog tsuas yog hauv zos thiab dav dav hom mob vwm. Nyob ntawm cov xwm txheej uas ua rau muaj qhov tshwm sim ntawm tus kab mob, cov ntaub ntawv hauv qab no yog qhov txawv:
- thawj: tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev ua kom lub hlwb nce ntxiv;
- theem nrab: tshwm sim los ntawm kev kis tus kab mob lossis raug mob;
- reflex: tshwm sim raws li cov tshuaj tiv thaiv rau qhov khaus, nws yuav yog ib lub suab nrov, flickering lub teeb, tsw.
Nyob ntawm lub hnub nyoog uas thawj cov tsos mob tshwm sim, thiab cov tsos mob tshwm sim, cov hom qaug dab peg no txawv:
- propulsive me, lawv raug rau me nyuam mos;
- myoclonic yog ib daim ntawv me nyuam yaus;
- impulsive, tshwm sim thaum puberty;
- psychomotor - lawv tuaj yeem nrog convulsions lossis dhau yam tsis muaj lawv, cov no tuaj yeem ua rau hnov, hnov lus, qaug dab peg, haum ntawm luag.
nyob ntawmqhov zaus ntawm qhov tshwm sim thiab kev sib dhos ntawm qaug dab peg, paub qhov txawv ntawm cov kab mob vwm:
- nrog tsawg (tsawg dua 1 zaug hauv ib hlis), nquag (txog ob peb zaug hauv ib lub lis piam) tawm tsam;
- nrog qaug dab peg thiab loj tuaj.
Cov hom kab mob vwm hauv qab no yog qhov txawv ntawm lub sijhawm tshwm sim:
- hmo;
- awakening;
- generalized (kev qaug dab peg tshwm sim txhua lub sijhawm).
Kev tsom mus rau kev ua kom muaj zog tuaj yeem nyob hauv occipital, cortical, lub cev, diencephalic thiab lwm qhov chaw ntawm lub hlwb.
Cov tsos mob tseem ceeb
Nyob ntawm qhov chaw ntawm qhov mob tseem ceeb, cov cim qhia ntawm kev mob vwm ntawm tus menyuam kuj yuav txawv. Tom qab tag nrho, tus kab mob tsis yog ib txwm manifested los ntawm convulsions. Kev tsis nco qab ib ntus, kev txav mus los, kev tsis sib haum xeeb hauv qhov chaw, kev cuam tshuam hauv kev nkag siab (swm, suab lossis pom), aggressiveness, kev hloov pauv ntawm lub siab yuav tsum ceeb toom. Tsis tas li ntawd, cov menyuam yaus loj tuaj yeem qhia qhov loog hauv qee qhov chaw ntawm lub cev.
Cov tsos mob ntawm tus me nyuam muaj mob qaug dab peg tsis tshua pom, yog li cov niam txiv tsis tas yuav saib xyuas lawv. Hauv cov menyuam yaus, lawv tuaj yeem ua yuam kev rau lawv qhov kev xav tsis zoo. Tab sis muaj cov cim qhia uas nyiam mloog. Qhov no yog ua pa nres, cov leeg nro ntawm lub cev, uas yog nrog los ntawm qhov tseeb hais tias tus me nyuam cov ceg ceg khoov thiab unbend, convulsive contractions, involuntary defecation, thiab tso zis. Tus neeg mob yuav tom nws tus nplaig, qee qhov qw thaum tawm tsam.
Qee zaum neeg qaug dab pegtrembling ntawm daim tawv muag, tilting lub taub hau rov qab, saib ntawm ib qho taw tes tsuas yog pom. Lawv tsis teb rau lwm stimuli. Tab sis ntau tus tsis paub txog kev qaug dab peg tshwj tsis yog tias lawv nrog convulsions thiab co hauv pem teb.
Koj yuav tsum paub tias kev tiv thaiv kab mob vwm tsis muaj zog heev. Lawv feem ntau raug kev txom nyem los ntawm ntau yam kev puas siab puas ntsws. Lawv tuaj yeem tsim kev ntxhov siab thiab kev nyuaj siab. Lawv yog cov me me thiab quarrelsome nyob rau hauv cov xwm, lawv feem ntau muaj bouts ntawm aggression. Cov neeg mob qaug dab peg yog tus cwj pwm los ntawm kev xaiv ntau dhau, kev ua siab phem, rancor. Cov kws tshaj lij hu qhov no yog tus cwj pwm vwm.
Kev kuaj kab mob
Pom lub sij hawm ntawm fading lossis convulsive txav ntawm tus menyuam, koj yuav tsum mus ntsib kws kho mob tam sim ntawd. Tsuas yog ib qho kev ntsuam xyuas tag nrho thiab xaiv txoj kev kho mob kom rov qab los rau tib neeg lub neej.
Kev kuaj tshwj xeeb thiab ntsuas ntsuas yog xav tau txhawm rau kuaj mob vwm nrog 100% tseeb. Pab pawg neeg xiam oob khab tau tsim ib zaug ua ntej hnub nyoog feem ntau. Tom qab qhov pib ntawm lub kaum yim xyoo, nws yuav tsum tau mus rau lub recommission.
Ib txoj hauv kev tseem ceeb ntawm kev kuaj mob yog electroencephalography. Muaj tseeb tiag, yuav luag ib nrab ntawm cov neeg mob hauv lub sijhawm ntawm kev tawm tsam yuav tsis muaj kev hloov pauv ntawm nws. Thaum kuaj kev ua haujlwm (hyperventilation, tsaug zog deprivation, photostimulation), 90% ntawm cov neeg mob tsim cov tsos mob ntawm tus kab mob vwm.
Ntxiv rau EEG, neuroimaging kuj tseem siv. nwstxoj kev tshawb no tso cai rau koj txheeb xyuas lub hlwb puas, tsim kom muaj kev kuaj mob, txiav txim siab txog qhov tshwm sim thiab kev kho mob ntxiv. Cov txheej txheem no suav nrog suav tomography thiab magnetic resonance imaging. Tsis tas li ntawd, cov neeg mob noj cov zis thiab ntshav rau kev tshuaj xyuas. Txiav txim siab theem ntawm immunoglobulins, transaminases, albumin, electrolytes, calcium, alkaline phosphatase, magnesium, qabzib, hlau, prolactin, thyroid hormones thiab lwm yam.
Kev tshawb fawb ntxiv suav nrog kev saib xyuas ECG, dopplerography ntawm brachiocephalic hlab ntsha, CSF tsom xam.
Kev xaiv kev kho mob tactics
Nws tuaj yeem ua rau tus menyuam tus mob zoo li qub thiab txo qis qhov qaug dab peg, lossis txawm tias tshem tawm tag nrho, nyob rau hauv rooj plaub ntawm kev xaiv zoo. Muaj tseeb, koj yuav tsum tsis txhob suav rau kev tshem tawm cov teeb meem hauv thawj lub hlis. Qee lub sij hawm koj yuav tsum tau noj tshuaj rau ntau xyoo kom lub hlwb qaug dab peg thiab kev tawm tsam nres kiag li.
Kev kho mob yuav tsum ua kom tiav. Ntxiv nrog rau qhov yuav tsum tau noj cov tshuaj tau sau tseg, qee zaum, kev kho mob neurosurgical yog qhov tsim nyog. Nws kuj yog ib qho nyuaj ua yam tsis muaj kev txhawb nqa psychotherapeutic. Nrog rau txoj hauv kev zoo, kev tso siab ruaj khov tuaj yeem ua tiav hauv 75% ntawm cov neeg mob hluas.
Ntxiv nrog rau kev kho tshuaj, cov kws kho mob qhia txog kev teeb tsa kev ua haujlwm txhua hnub rau tus menyuam thiab hloov nws mus rau kev noj zaub mov tshwj xeeb. Txoj kev ua neej no yuav tsum ua ib tug cwj pwm. Tom qab tag nrho, hom minimizes qhov tshwm sim ntawm foci ntawm excitation nyob rau hauv lub hlwb. Cov kws kho mob tseem nco ntsoov tias kev noj zaub mov ketogenic muab cov txiaj ntsig zoo. Nws lub ntsiab lus nyob hauv qhov tseeb tiasnoj zaub mov muaj rog. Nyob rau tib lub sijhawm, nws yog qhov tsim nyog los txo cov carbohydrates.
Txoj kev kho tshuaj
Txiav txim siab seb yuav kho tus mob qaug dab peg hauv txhua kis, yuav tsum tsuas yog kws kho mob uas muaj kev paub txaus. Tom qab tag nrho, nws yog ib qho tseem ceeb uas yuav tau xaiv cov tshuaj nyob rau hauv xws li ib txoj kev uas lawv tau txais txiaj ntsig siab tshaj plaws nrog rau qhov tsawg kawg nkaus ntawm qhov tsis zoo. Kev kho mob pib tsuas yog tom qab kev kuaj mob tau tsim. Txhawm rau sau cov tshuaj no lossis cov tshuaj ntawd, tus kws kho mob yuav tsum txiav txim siab qhov xwm txheej ntawm qhov qaug dab peg, coj mus rau hauv tus account cov yam ntxwv ntawm cov kab mob. Lub luag hauj lwm yog ua si los ntawm lub hnub nyoog ntawm kev tawm tsam pib, lawv zaus, tus neeg mob qhov kev txawj ntse, muaj cov tsos mob ntawm neurological. Cov tshuaj toxicity ntawm cov tshuaj thiab qhov tshwm sim ntawm cov kev mob tshwm sim kuj raug coj mus rau hauv tus account. Thaum xaiv cov tshuaj (rau cov neeg mob qaug dab peg, feem ntau yog cov tshuaj tiv thaiv kab mob), tus kws kho mob yuav tsum tau saib xyuas ntau dua rau qhov kev tawm tsam, daim ntawv ntawm tus kab mob tsis tseem ceeb.
Rau cov hom phiaj kho mob, cov neeg mob tau muab tshuaj rau hnub nyoog li ib txwm. Muaj tseeb, tus kws kho mob yuav tsum piav qhia txog txoj cai. Tom qab tag nrho, lawv pib haus cov tshuaj antiepileptic nrog rau qhov qis dua. Yog hais tias cov nyhuv ntawm kev noj lawv tsis tshwm sim, los yog nws yog NW nyuam qhuav pom, nws yog ib qho tsim nyog yuav tsum tau maj mam nce qhov ntau npaum. Ib tug feature ntawm kev kho mob ntawm tus kab mob no yog precisely hais tias nws yog undesirable hloov cov tshuaj. Yog hais tias lub cev tsis teb, koj tsuas yog yuav tsum tau nce tus nqi ntawm ib koob tshuaj. Txawm hais tias kwv yees li 1-3% ntawm cov neeg mob tau txais kev kho mob nrog txo qisQhov nruab nrab ntau npaum li cas.
Kev xaiv tshuaj
Tseem muaj qee zaus uas cov tshuaj kws kho mob tsis pab. Qhov no yog pov thawj los ntawm qhov tsis muaj kev txhim kho thoob plaws lub hli, yog tias qhov siab tshaj plaws hnub nyoog ntau npaum li cas. Hauv qhov xwm txheej zoo li no, nws yog qhov yuav tsum tau hloov cov tshuaj. Tab sis nws tsis yooj yim ua li ntawd. Muaj ib lub tswv yim tshwj xeeb rau kev kho mob qaug dab peg nrog ntau yam tshuaj.
Txhawm rau hloov cov nyiaj, cov tshuaj thib ob tau pib pib maj mam, thiab qhov dhau los raug muab tso tseg tib lub sijhawm. Tab sis nws ua tau zoo. Qee lub sij hawm qhov kev hloov ntawm cov tshuaj yog ncua rau ob peb lub lis piam. Yog hais tias tus neeg mob muaj ib tug pronounced tshem tawm syndrome, ces nws yog advisable mus muab benzodiazepines thiab barbiturates raws li ib tug complex txoj kev kho.
Nyob rau hauv feem coob ntawm cov neeg mob qaug dab peg tuaj yeem kho tau. Tus kws kho mob ib leeg xaiv cov tshuaj anticonvulsant thiab anticonvulsant. Feem ntau, "Diazepam", "Phenobarbital", "Carbamazepine". Preference yog desirably muab rau cov neeg ua hauj nyob rau hauv uas cov active tshuaj yog tso tawm maj mam. Tom qab tag nrho, lawv siv txo qhov kev pheej hmoo ntawm kev phiv. Cov tshuaj no suav nrog derivatives ntawm valproic acid thiab carbamazepine. Cov no suav nrog cov ntsiav tshuaj "Valparin XP", "Konvulsofin", "Enkorat", "Konvuleks", "Depakin Enteric 300", "Finlepsin", "Apo-carbamazepine".
Muaj Teeb Meem
Kev xaiv txoj kev kho kom raug tuaj yeem tshem tawm cov tsos mob ntawm tus mob qaug dab peg hauv tus menyuam ob peb xyoos. Qee zaum, kev kho mob monotherapy tsis nres. nwsua tau nrog tshuaj tiv thaiv. Feem ntau, nws tau pom nyob rau hauv cov neeg mob uas pib qaug dab peg thaum ntxov, muaj ntau tshaj 4 qaug dab peg ib hlis twg, muaj qhov txo qis hauv kev txawj ntse thiab lub hlwb dysgenesis. Nyob rau hauv cov ntaub ntawv no, ib tug me ntsis txawv tswvyim yuav tsum tau kho rau mob vwm ntawm lub hlwb. Koj tus kws kho mob yuav sau ob yam tshuaj tib lub sijhawm.
Kev kho mob raws li cov txheej txheem xaiv yuav tsum tau ua rau ntau xyoo thiab txawm tias tom qab ua tiav kev qaug dab peg. Nyob ntawm cov ntaub ntawv ntawm kev qaug dab peg, lub sijhawm no tuaj yeem yog los ntawm 2 mus rau 4 xyoo. Tab sis kev tshem tawm ntxov ntxov ntawm cov tshuaj tuaj yeem ua rau muaj qhov tsis zoo. Kev qaug dab peg tuaj yeem tshwm sim. Txawm tias tom qab kawg ntawm lub sijhawm teev tseg, kev tshem tawm ntawm cov nyiaj yuav tsum tau maj mam dhau 3-6 lub hlis. Nws yog ib qho tseem ceeb uas yuav tau saib xyuas tus mob tsis tu ncua siv EEG. Qee qhov xwm txheej, kev kho mob yog nyob mus ib txhis.
Nws yuav tsum to taub tias tus kab mob pib ua ntej, qhov tshwm sim ntawm kev mob vwm tuaj yeem loj dua. Qhov no yog vim qhov tseeb tias thaum muaj hnub nyoog ntxov, tib neeg lub hlwb tseem tsis paub qab hau thiab, vim li ntawd, muaj kev pheej hmoo ntau dua. Cov niam txiv yuav tsum tau ua raws li kev kho mob tshwj xeeb, vim tias yog tias koj tsis ua raws li cov kev xaiv kho mob, hla kev noj tshuaj lossis tshem tawm koj tus kheej, tus menyuam tuaj yeem rov qab qaug dab peg mus txog qhov tshwm sim ntawm tus kab mob epilepticus. Tus mob no tshwm sim los ntawm qhov tseeb tias tus me nyuam qaug dab peg mus ib txhis tsis muaj kev cuam tshuam, kev nco qab ntawm lawv tsis meej.
