Tolosa-Hunt chirwere: kuongorora chirwere uye kurapwa

Pasinei mukuru nenhanho kugadzira mishonga, zvimwe zvirwere havana kudzidza kusvikira pakuguma. Mumwe zvirwere izvi anorondedzera Tolosa-Hunt syndrome. Parizvino pane chete zviratidzo nehosha, apo zvikonzero hadzisati pachena zvakazara. Ungangove, ichi imhaka ndechokuti chirwere hariwanikwi chaizvo uye yakazaruka kudaro kare. Uyewo, Tolosa-Hunt chirwere kazhinji "Masked" nevamwe pathologies, uye zviri nyore kuti vazivikanwe. The chikuru chiratidzo chiri ziso chirwere uye cranial tsinga. Zvinozivikanwa kuti mumwe hunhu chirwere ichi anonzi kuva chokwadi chokuti anongokurukurwa kemikari kurapa, pashure izvo anokurumidza kuvandudzika. Zvisinei, kuitazve anogona kuitika chero nguva.

Description chirwere Tolosa-Hunt

The kutaurwa chirwere ichi chokutanga aoneka nekaupenyu achangobva. Rakanga anotsanangurwa 1961 maererano British ophthalmologist Hunt. Kuwedzera huru musoro, uye zvokurwara akadana zvakasiyana zvakadai se "norwaivhi". Izvi imhaka yokuti zviratidzo ayo akafanana nezvimwe zvirwere zvakawanda. Pakati pavo: Mamota musoro, chirwere encephalitis, myositis muchadenga uye kunyange zvirwere zviri hematopoietic hurongwa. Mukuwedzera, zvokurwara pakati Tolosa-Hunt akadana chiratidzo hukuru orbital kutsemuka uku usingabereki zvakarurama kuratidza musimboti dambudziko. The kunotoda mufananidzo chirwere kunoenderana worudzii pfungwa tsinga vaiomerwa. Kakawanda, Tolosa-Hunt chirwere kunoratidzwa marwadzo muziso panosangana, nekusagona kufamba maziso, diplopia. Kana nenguva atanga kemikari kurapa anogona kurapa kana kuramba kanganwiro.

The aetiology of chirwere Tolosa-Hunt

Nokuti kuti zvokurwara ane kuratidzwa siyana uye kunotanga nokukurumidza, hazvina kukwanisa kuona chaiyo etiology asi. It kunewo chokuita yakaderera panowanikwa syndrome. Nokuda kwechikonzero ichi, vanachiremba havana nzira kuongorora zvakanaka chirwere. Kune zvekungofungira akawanda, maererano zvinogona kukudziridza zvokurwara. Govera zvinotevera etiological zvinhu zvinowanikwa varwere Tolosa-Hunt urwere:

1. Malformation. Izvi izwi rinoreva zvemamiriro kukura vascular ezvinhu neziso. Somugumisiro malformations vari vakavhengana venous uye arterial ropa, izvo zvinofanira kuva zvakajairika. kutyora Iri anonyanya pakati pavakadzi.
2. Autoimmune kurwisa. chinokonzera Iri chikungiso zvirwere zvakawanda. Zvisinei, kupindura mubvunzo wokuti nei masoja masero vanotanga kuparadza nyama dzomuviri, uye haagoni. Kazhinji, "utsinye" rinowanika pashure kutambura mupfungwa, uye nguva yose ano rwarisa kwendangariro.
3. Siyana pfungwa namamota uye cranial tsinga. Zvinogona kuva benign namamota uye kenza.

Syndrome Development Mechanisation

Akapiwa chokwadi chokuti etiology kuti chirwere chinoramba isingazivikanwi, pathogenesis, zvakare, haagoni zvakazara Akaongorora. Pasinei zvikonzero dzichiri zvokurwara inobata chete vamwe hurongwa ziso uye huta tishu. Sezvo chikazozikamwa, zita rechipiri chirwere - munhu chirwere nani orbital kutsemuka uku. Izvi chokuita pathogenesis, sezvo kukundwa pachena tsinga uye tsinga kuti vafambe nayo. Chekutanga pane kuchinja kubva ophthalmic tsinga uye tsinga. Somugumisiro kwakakanganiswa tishu trophism. Uyezve, zvakakuvadza cavernous sinus, riri pedyo pevane orbital kutsemuka uku. Tsinga kugoverwa nayo, kuva anorwadza uye tishu hypertrophy. Sezvaunoziva, kuburikidza pakakoromoka kuburikidza inotevera cranial tsinga: yacho anovhara, achitora kure chikamu trigeminal uye oculomotor. Mune zvimwe zviitiko, kwakakanganisa majoko ose aya. Panguva iyoyo nayo chirwere kukwanisa tenderera yeziso. Dzimwe nguva vasingadzoreki basa rimwe kana maviri yegwara tsinga.

Tolosa-Hunt urwere: Zviratidzo

Zvokurwara kazhinji inoita pacharo akafunga mukati pakati uye kukwegura. chirwere ichi chingava asingatani vose vakadzi nevarume. The kunotoda Mufananidzo chirwere hwapedyo pakarepo, pasina chinhu preconditions. Kusiyanisa zvinotevera zviratidzo:

1. Kurwadziwa ophthalmic mumunda. Kusagadzikana kutanga kuonekwa pahuma, pahuma, musoro. Gare gare yakakura kwazvo neshungu, izvozvo asiwo ziso.
2. Diplopia. Ichi chiratidzo sokuti pashure dzichiri marwadzo. Murwere sokuti kuva kuti zvose zvinhu kuti icho anotarira forked. Nyanya kutarisa nesimba.
3. Kutyora mufambo yeziso - ophthalmoplegia. Kazhinji akacherechedza neruoko rumwe. kukura kwayo kunobva kusimba uye uwandu kwakakanganisa utano hwake.
4. Kuzvimba conjunctiva.
5. Exophthalmos. Akacherechedza pasina kurapwa uye kakawanda zvazvo.
6. Strabismus. It apo tsinga Vakundwa rimwe divi chete.
7. nefivha Low-mugiredhi uye kudzikira.

Zviratidzo izvi kazhinji kukura zvishoma nezvishoma uye kutevera mumwe. Mune zvimwe zviitiko zvavari vakachengeta panguva. Zviratidzo zviri chirwere anogona pakarepo kunyangarika, sezvavakanga azviratidza. Zvisinei, pasina Mabatirwo zvokurwara nguva dzose anoita pacharo sokuti zvakare. The dzokororo zvazvingava zvachose siyana sezvo kanganwiro refu.

Tolosa-Hunt chirwere: chirwere zvokurwara

Kuti tizive zvokurwara ichi yakaoma, sezvo zviratidzo ayo akafanana nezvimwe zvirwere zvakawanda. Naizvozvo Tolosa-Hunt chirwere anoonekwa chirwere chokudzingwa. Murwere wokutanga akabvunza pamusoro zvinoitwa chirwere kunoita (kutanga, sezvo zviratidzo kuva). Pashure paizvozvo, murabhoritari nemiedzo uye richishanda Diagnostics. Zvakakosha chaizvo kuti abate ophthalmic uye chetsinga kuzviongorora. Kubvisa mapundu uropi, MRI rinoitwa. Zvinokoshawo kuti kuitisa Ultrasound uye X-ray pakuongorora ziso nezvigadziko. Kuvapo vascular malformations chirevo angiography. Uyezve, mumwe chirwere nzira ndiyo kubudirira kemikari mishonga. Kana murabhoritari uye richishanda kuongororwa kwakaratidza pasina raidudzwa kuchinja, uye zviratidzo nokukurumidza zvigume pashure kurapwa, zvingangoita, nechirwere - Tolosa-Hunt syndrome. Prednisolone inoshandiswa kurapa zvikuru.

Differential chirwere pamwe nezvimwe zvirwere

The chirwere ichienzaniswa nedzimwe pathologies ziso uye tsinga. Danho rokutanga kuti asava anogumbura dzinotsanagura uropi uye ayo meninges, uye anomera. Kana uchifungidzira yomumuzongoza kana encephalitis, mumwe lumbar ponji rinoitwa. Kuitira kudzivisa benign namamota uye kenza varwere ndavhiyiwa MRI, pfungwa CT Scans uye maekisirei yacho dehenya. The chirwere kusiyaniswa rwekenza yelymphoma, cysts ari cavernous sinus uye thrombosis. Sezvo Zviratidzo izvi zvinogona kuitika systemic pathologies akadai sarcoidosis, myositis muchadenga, migraine, etc. Kuti kuongororwa zvakarurama, murwere vanofanira kuona vanachiremba dzakasiyana: .. An ophthalmologist, wetsinga, vascular chiremba, imwe endocrinologist.

Mabatirwo Tolosa-Hunt urwere

Mabatirwo Tolosa-Hunt chirwere ndicho kugadzwa zvinodhaka kuti vasaziva zvirwere. Nokuti chinangwa ichi, kemikari tubhokisi zvinodhaka: "Prednisolone", "Hydrocortisone". zvinodhaka izvi zvine zvazvinoita pane vamwe autoimmune pathologies, asi chirwere zviratidzo inonyangarika mukati memazuva 3-4. urwere, Tolosa-Hunt kurapwa pamwe prednisolone kubva kukarukureta pamusoro 1-2 MG / makirogiramu muviri uremu. Kana mushonga unoshandiswa muchimiro kugadzirisa, zvinonzi ushandiswe 500 kusvika 1000 MG pazuva. Uyezve, kushandisa inonyaradza marwadzo omusoro uye mavhitaminzi.

Kukwanisa kushanda pamwe chirwere Tolosa-Hunt

Kazhinji, kana chirwere ichi akaremara varwere vakaponeswa. Unofanira kuva nechokwadi kuti murwere ari Tolosa-Hunt syndrome. Disability zvokurwara ichi hariwanikwi. Zvisinei, kana kakawanda zvazvo anogona kunan'anura 3 boka. Murwere anofanira hwakatamisirwa chiedza basa kuti haatarisiri nokuona nesimba. Uyewo, kana kuramba tsinga chirwere murwere haagoni kutyaira marori kubva zvaipesana ziso rwokufamba diplopia.

Syndrome Prevention Tolosa-Hunt

Pachine kufanotaura chitange Tolosa-Hunt chirwere hazvibviri, saka, chikuru kudzivirira haako. Kana pane zviratidzo zvakadai marwadzo mumaziso uye huma, diplopia, unofanira kuitisa kwazvo kuongorora chirwere. Apo Tolosa-Hunt chirwere zvakakodzera kuita kudzivirira yechipiri. Izvi zvinosanganisira yakakodzera kemikari kurapa, kutapata rutsigiro. Unofanirawo kudzivisa anoshungurudza ezvinhu uye anogumbura kwendangariro.