Tolosa-Hunt syndrome: ukuxilongwa kanye nokwelashwa

Naphezu ezingeni lelisetulu ukuthuthukiswa imithi, ezinye izifo kungukuthi wafunda kuze kube sekupheleni. Ukuze esinye salezi zifo uyalandisa Tolosa-Hunt syndrome. Okwamanje kukhona izimpawu kuphela lesi sifo, kanti izizathu azikakabi kudalulwe ngokuphelele. Cishe, lokhu kungenxa yokuthi lesi sifo ezingavamile kakhulu futhi ivulekile akunjalo kudala. Ngaphezu kwalokho, Tolosa-Hunt syndrome ngokuvamile "simaskwe" ngamanye pathologies, futhi kulula ukudida. Uphawu oyinhloko kuyinto isifo samehlo nezinzwa cranial. Kuyaziwa ukuthi esinye sezici yalesi sifo ubhekwa iqiniso ukuthi ikufanele yokwelapha i-hormone, ngemva kwalokho ngokushesha kuza ngcono. Nokho, lokubuya kwesifo singenzeka nganoma yisiphi isikhathi.

Incazelo syndrome Tolosa-Hunt

Lapho kukhulunywa ngaye okokuqala kule sifo esanda kutholakala. Yayibizwa echazwe 1961 yi-British ophthalmologist Hunt. Ngaphezu isihloko esikhulu, pathology ngokuthi ehlukile ezifana "chameleon". Lokhu kungenxa yokuthi izimpawu zaso zifane nezinye izifo eziningi. Phakathi kwabo: izimila ikhanda, encephalitis ezithathelwanayo, myositis orbit ngisho nezifo kohlelo hematopoietic. Ngaphezu kwalokho, zokugula of Tolosa-Hunt ngokuthi uphawu aphakeme ZaseLaki esemkhathini okungahambisani ibonisa kahle okushiwo inkinga. Isithombe emitholampilo ye isifo kuncike onjani nezinzwa ubuchopho zathinteka. Ngokuvamile, Tolosa-Hunt syndrome libhekene ubuhlungu isokhethi iso, ukungakwazi ukuhambisa amehlo, diplopia. Lapho ngesikhathi esifanele waqala ukwelashwa i-hormone umphilise noma ukuthethelelwa okuqhubekayo.

I aetiology yalesi sifo Tolosa-Hunt

Ngenxa yokuthi i-pathology has ukubonakaliswa letimbili letehlukene, ucala ngokuzumayo, akukabi akwazi ukunquma etiology ngqo. It buhlobene futhi okuyinto ongaphakeme yalesi sifo. Ngenxa yalesi sizathu, odokotela abanalo yezindlela zokuhlola kahle lesi sifo. Kukhona ezizathwini eziningi, ngokusho kwe ezingasetshenziswa ukuthuthukisa egunjini lokuhlolwa kwezifo. Ukunikeza lezi zinto ezilandelayo etiological ayatholakala in iziguli Tolosa-Hunt syndrome:

1. Malformation. Leli gama lisikisela ukuthuthukiswa okungavamile ohlelweni semithambo esweni. Ngenxa yalokho kombungu kukhona okuxubile pooling eyeqile lwemithambo yegazi, okuyinto akufanele kube evamile. Lokhu ukuhlukumeza landile phakathi kwabesifazane.
2. ubudlova sokuhlasela kwamasosha omzimba. Lokhu isici inhlamvu izifo eziningi. Nokho, impendulo yombuzo othi kungani amangqamuzana okuzivikela uqale ukubhubhisa izicubu emzimbeni, futhi awukwazi. Ezimweni eziningi, "ubudlova" kwenzeka ngemuva kokuxinwa ukucindezeleka, kanye nesikhathi izinqubo ezithathelwanayo zamanje.
3. Ezahlukene izimila ebuchosheni nezinzwa cranial. Kungaba njengoba izimila ingozi kanye nomdlavuza.

Mechanism Syndrome Development

Sikhishwe yokuthi etiology lesi sifo ayikaziwa, pathogenesis, kakhulu, asikwazi kwehlwaywe. Kungakhathaliseki izizathu ekuthuthukiseni zokugula kuthinta kuphela izakhiwo ezithile iso nezicubu sezinzwa. Njengoba yaziwa, igama lesibili yesifo - a syndrome aphakeme ZaseLaki esemkhathini. Lokhu lihlotshaniswa pathogenesis, kusukela ukunqotshwa imizwa obala futhi imithambo yegazi idlule ke lokho. Okokuqala kukhona izinguquko kusuka vein amehlo futhi Umthambo. Ngenxa iphazamiseke izicubu trophism. Ngaphezu kwalokho, ezilimele itheku cavernous, eyakhelene aphakeme ZaseLaki esemkhathini. Umthambo kokunikeza ke, baba elikhanyayo futhi hypertrophy izicubu. Njengoba wazi, esikhaleni ngokusebenzisa okulandelayo cranial izinzwa: block, thatha ususe ingxenye trigeminal futhi oculomotor. Kwezinye izimo, abathintekayo zonke lezi ngazimbili. Ngesikhathi esifanayo ke uhlushwa ikhono ukushintshanisa inhlamvu yeso. Ngezinye izikhathi kahle umsebenzi owodwa noma amabili namabhuzu izinzwa.

Tolosa-Hunt syndrome: izimpawu

Pathology livamile ngokwayo wazizwa yobudala emaphakathi futhi ubudala. Lokhu syndrome zingase zihlale kwabesifazane nabesilisa. Isithombe emitholampilo ye isifo eba ngokuzumayo, ngaphandle preconditions. Hlukanisa zimpawu ezilandelayo:

1. Ubuhlungu emkhakheni amehlo. Ukungakhululeki athoma ukuvela ngaphakathi ebunzini, brow, ikhanda. Kamuva wachaza ukushuba ubuhlungu, nangabo iso.
2. Diplopia. Lokhu uphawu livela ngemva kokuthandana ubuhlungu. Isiguli ibonakala ukuthi zonke izinto lapho kubukeka olunjengemfoloko. Focus bheka kanzima.
3. Ukwephula ukuhamba yeso - ophthalmoplegia. Ngokuvamile waphawula ngesandla esisodwa. ngokwezinga kwakho kuncike umfutho kanye nenani nezinzwa abathintekayo.
4. Ukuvuvukala conjunctiva.
5. Exophthalmos. Kubonakala ukungabi sokwelashwa uyahluleka uma elwa nokuphuza njalo.
6. Strabismus. Kwenzeka lapho izinzwa zifikelwa ohlangothini olulodwa kuphela.
7. Low-grade imfiva kanye ukuwohloka.

Lezi izimpawu zivame ukuba zikhule bese ulandela nomunye. Kwezinye izimo kuyagcinwa kanyekanye. Izimpawu zesifo singazelele zinyamalale, njengoba nje uvele. Nokho, ngaphandle kokwelashwa zokugula kwenza njalo ngokwayo wazizwa futhi. Izinga Ukuphinda nhlobo ezahlukene njengoba ukuthethelelwa isikhathi.

Tolosa-Hunt syndrome: zokugula zokuxilonga

Ukukhomba lokhu zokugula kunzima, njengoba izimpawu zaso zifana nezinye izifo eziningi. Ngakho-ke Tolosa-Hunt syndrome kubhekwa kungatholakali ngokushesha ukuthi uphethwe inyumbazane. Isiguli kuqala ngemibuzo izici ukuqhubekela phambili kwesifo (ukuqala, njengoba izimpawu ukuthuthukisa). Ngemva kwalokho, le ukuhlolwa laboratory nokuhlola wezinsimbi. Kubalulekile kakhulu ukubamba luhlolo amehlo futhi zezinzwa. Ukuze ususe izimila ebuchosheni, i-MRI wenziwa. Kubalulekile futhi ukuba ukuqhuba ultrasound kanye-X-ray Ukuhlola iso enethiwekhi. Ukuba khona kombungu semithambo kunqunywa angiography. Ngaphezu kwalokho, omunye nenqubo Kuhlolisisa ukusebenza yokwelapha i-hormone. Uma i-laboratory kanye luhlolo wezinsimbi wembula akukho izinguquko evelele, futhi izimpawu ngokushesha kuphele emva kokwelashwa, kungenzeka, uphethwe - Tolosa-Hunt syndrome. Prednisolone isetshenziswa ukwelapha kakhulu.

Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa nezinye izifo

Lesi sifo, uma iqhathaniswa nezinye pathologies esweni futhi isimiso sezinzwa. Isinyathelo sokuqala ukuba ngakususi izinqubo ukuvuvukala kobuchopho futhi meninges yayo, futhi izimila. Uma usola meningitis noma encephalitis, a wokubhoboza lumbar wenziwa. Ukuze uvimbele izimila ingozi futhi zabasiza abathile abanomdlavuza kwavele MRI, ubuchopho CT scan kanye -X ray Yekhanda. Lesi sifo lymphoma umahluko, izinhlumba we itheku cavernous futhi thrombosis. Njengoba lezi zimpawu kungenzeka pathologies letindzala ezifana sarcoidosis, myositis orbit, migraine, njll Ukuze wenze i-ukusazi ngokunembile isifo esikuphethe, isiguli kufanele ubone Ochwepheshe ezahlukene: .. An ophthalmologist, udokotela wezinzwa, udokotela ohlinza imithambo yegazi, i-endocrinology.

Ukwelashwa nokuvikelwa Tolosa-Hunt syndrome

Ukwelashwa nokuvikelwa Tolosa-Hunt syndrome ukuqokwa izidakamizwa ukuthi nesimiso somzimba sokuzivikela. Ngenxa yale njongo, i-hormone-equkethe imithi: "Prednisolone", "Hydrocortisone". Le mithi nomthelela kwezinye pathologies sokuhlasela kwamasosha omzimba, kodwa izimpawu isifo zinyamalale ngaphakathi 3-4 izinsuku. ngalesi sifo, Tolosa-Hunt ukwelashwa nge prednisolone ivela ekubalweni 1-2 mg esisindo / kg. Uma izidakamizwa isetshenziswa ngendlela isixazululo, it is ebekiwe 500 kuya 1000 mg ngosuku. Ngaphezu kwalokho, amaphilisi ezinhlungu ukusetshenziswa namavithamini.

Amandla ukusebenza lesi sifo Tolosa-Hunt

Ngokuvamile, lapho le uphethwe zikhutshaziwe iziguli ukulondolozwa. Kufanele uqiniseke ukuthi isiguli Tolosa-Hunt syndrome. Ukukhubazeka kule zokugula akuvamile. Nokho, lapho umuntu uyahluleka uma elwa njalo angaqoka 3 iqembu. Isiguli kufanele idluliselwe umsebenzi ukukhanya ukuthi akudingi mzamo ezibukwayo. Futhi, uma eziphikelelayo isifo ezinzwa isiguli singenakukwazi ukushayela amaloli kusukela ukwephulwa iso ukunyakaza futhi diplopia.

Syndrome Prevention Tolosa-Hunt

Kusengaphambili ukubikezela ukuthuthukiswa Tolosa-Hunt syndrome akunakwenzeka, ngakho-ke, zokuvimbela eyinhloko alikho. Uma kukhona izimpawu ezifana ubuhlungu emehlweni nebunzi, diplopia, kufanele ukuqhuba ukuxilongwa ngokuphelele. Lapho Tolosa-Hunt syndrome idingekile ukuze zokuvimbela yesibili. Lokhu kuhlanganisa ngesikhathi esifanele ukwelashwa i-hormone, amasosha omzimba ukwesekwa. Kudingeka nokuba sigweme izimo ezibangela ukucindezeleka futhi izinqubo ukuvuvukala.