Paraparesis inzira yakapfava yekuoma mitezo yepasi iyo iri genetic kana kukonzerwa nehutachiona. Marwadzo uye spasms zvinogona kuderedzwa nemishonga, uye kurapwa kwemuviri uye kurovedza muviri zvinogona kuchengetedza kufamba uye simba retsandanyama.

Tsanangudzo yeparaparesis

Paraparesis ishoko rezvokurapa rinoshandiswa kuratidza kushaya simba kunofambira mberi kunoperekedzwa nemisungo contractures (spastic weakness) muzasi. Icho chimiro chakapfava cheparaplegia (kuoma mitezo yemakumbo ezasi).

Spastic paraparesis iboka rezvirwere zvinokonzerwa nekukanganiswa kwemutsipa wepelinha.

Mhando dzeparaparesis

Spastic paraparesis inogona kugarwa nhaka kana kukonzerwa nehutachiona.

Hereditary spastic paraparesis

Iwo akakamurwa kuita asina kuomesesa (kana akachena) uye akaomarara (kana akaomarara) mune iyo kirasi zviratidzo zvepazasi makumbo spasticity inoperekedzwa nezvimwe zviratidzo zvakaita se:

• Cerebellar atrophy: kuderera kwevhoriyamu kana kukura kwecerebellum
• A thin corpus callosum (kusangana pakati pehemispheres mbiri dzeuropi)
• Ataxia: kufamba kwekubatana kusagadzikana nekuda kwekukuvadza kune cerebellum

Genetic, spastic paraparesis inogona kuiswa maererano nemaitiro avo ekutapurirana:

• Inotonga: zvakakwana kuti kusajaira kunokanganisa kopi imwe chete yejini kuti chirwere chiwedzere.
• Recessive: anomaly inofanirwa kukanganisa makopi ese ejini, imwe neimwe yakagarwa nhaka kubva kune mumwe wevabereki, kuti chirwere chiwedzere.
• X-yakabatana: Varume, vane X chromosome imwe chete, vanowana chirwere ichi kana vakatakura zvisirizvo mukopi imwe chete yejini.

Tropical spastic paraparesis

Iyo inonziwo HTLV-1 yakabatana myelopathy, chirwere chinokura zvishoma nezvishoma chemusana chinokonzerwa nehutachiona hwemunhu lymphotrophic T rudzi 1 (HTLV-1).

Zvikonzero zve spastic paraparesis

Hereditary spastic paraparesis inogona kuve mhedzisiro yemhando dzakawanda dzema genetic abnormalities kana inogona kukura yega. Parizvino, 41 mhando dzenhaka spastic paraparesis dzinozivikanwa, asi 17 chete iyo iyo inokonzera gene yakaonekwa.

Tropical spastic paraparesis inokonzerwa nehutachiona hweHTLV-1.

chirwere

Hereditary spastic paraparesis inofungidzirwa nekuda kwekuvapo kwenhoroondo yemhuri uye chero chiratidzo che spastic paraparesis.

Kuongororwa kunotanga kubva pakusabatanidzwa kwezvimwe zvikonzero zvinogona kukonzera:

• Adrenoleukodystrophy, X-yakabatana neurodegenerative chirwere
• Multiple sclerosis
• Chirwere chinosanganisira upper motor neuron (primary lateral sclerosis kana amyotrophic lateral sclerosis)
• Hutachiona hweHIV kana HTLV-1
• Kushaikwa kwevhitamini B12, vhitamini E kana mhangura
• Spinocerebellar ataxia, chirwere chinonzi neuromuscular chinokanganisa cerebellum
• A spinal arteriovenous malformation
• Bundu remwongo
• Cervicoarthritis myelopathy, kupfupika kwemugero wemusana unomanikidza cervical cord.

Kuongororwa kwenhaka spastic paresis dzimwe nguva kunoitwa kuburikidza nekuongororwa kwemajini.

Vanhu vane hanya

Hereditary paraparesis inobata vanhukadzi vese zvisina tsarukano uye inogona kuitika chero zera. Inobata vanhu vatatu kusvika gumi mu3.

Zvinhu zvinotyisa

Ngozi yekuwana utachiona hwenhaka yakakura kana paine nhoroondo yemhuri. Kana iri tropical spastic paraparesis, njodzi yekubatwa nechirwere ichi inoenderana nenjodzi yekusangana nehutachiona hweHTLV-1, iyo inotapurirwa kuburikidza nekusangana pabonde, kushandiswa kwezvinodhaka zvisiri pamutemo mutsinga kana kuburikidza neropa. Inogona zvakare kutapurirwa kubva kuna amai kuenda kumwana kuburikidza nekuyamwisa.

Spasticity yemakumbo ezasi

Spasticity inotsanangurwa nekuwedzera kwe tonic stretch reflex, kureva kuwedzeredza reflex muscle contraction. Iyo inokonzeresa yakakwira tsandanyama toni iyo inogona kuve iyo honzeri yekurwadziwa uye spasms, uye kukonzera kusashanda kwemaoko nemakumbo.

Motokari kushomeka

Vanhu vane paraparesis vanowanzoomerwa nekufamba. Vanogona kugumburwa nokuti vanowanzofamba nezvigunwe zvavo, tsoka dzavo dzakatendeudzira mukati. Bhutsu dzinowanzokuvadzwa muchigunwe chikuru. Vanhu vanowanzova nechinetso chokuburuka masitepisi kana kuti pamateru, kupinda pachigaro kana kuti mumotokari, kupfeka, uye kushambidzika.

Asthenia

Asthenia kuneta kusina kujairika kana ichienderera kunyange mushure mekuzorora. Zvinokonzera kunzwa kwekutadza kuita mabasa ezuva nezuva.

Proprioceptive kusagadzikana

Kurasikirwa nekunzwa kwenzvimbo yetsoka nezvigunwe

Zvimwe zviratidzo

Mune mafomu asina kuoma, isu tinogona zvakare kuona:

• Kukanganisa kunyoro kwevibratory senitivity
• Urinary zviratidzo (incontinence)
• Makomba matsoka

Mune mafomu akaoma,

• Ataxia, kusagadzikana kwekubatana kwekufamba kwetsinga
• Amyotrophie
• Optic atrophy
• Retinopathy pigmentosa
• Kudzora pfungwa
• Extrapyramidal zviratidzo
• Dementia
• Matsi
• Peripheral neuropathy
• pfari

Kurapa kune zviratidzo, kusanganisira mishonga yekubvisa spasticity.

• Systemic zvinodhaka kurapwa: baclofen, dantrolene, clonazepam, diazepam, tizanidine, benzodiazepines
• Mishonga yemunharaunda: anesthetic block, botulinum toxin (yakananga intromuscular), doro, kuvhiyiwa (selective neurotomy)

Kurapa kwemuviri uye kurovedza muviri kunogona kubatsira kuchengetedza kufamba uye simba remhasuru, kunatsiridza huwandu hwekufamba uye kutsungirira, kuderedza kuneta, uye kudzivirira spasms.

Vamwe varwere vanobatsirwa nekushandiswa kwesimbi, mudonzvo kana madondoro.

Kune tropical spastic paraparesias, marapiro akati wandei anogona kubatsira kurwisa hutachiona:

• Interferon alpha
• Immunoglobulin (mutsinga)
• Corticosteroids (yakadai semuromo methylprednisolone)

Kudzivirira kubata tropical spastic paraparesis, kubata nehutachiona hweHTLV-1 kunofanirwa kudzikiswa. Inoparidzirwa ne:

• Kusangana pabonde
• Kushandisa zvinodhaka zvisiri pamutemo
• Kubuda ropa

Inogona kutapurirwa kubva kuna amai kuenda kumwana kuburikidza nekuyamwisa. Izvo zvinowanzoitika pakati pepfambi, vanoshandisa zvinodhaka, vanhu vari pahemodialysis uye huwandu hwevanhu mune mamwe matunhu anosanganisira pedyo neequator, kumaodzanyemba kweJapan neSouth America.