Neuromyelite Optique

Neuromyelitis optica, izwi kandi nka NMO, ni indwara ifata urubuga rw'imitekerereze rukuru ikaba itera ububabare mu mitsi y'ijisho no mu mugongo.

NMO ikunze kwitwa neuromyelitis optica spectrum disorder (NMOSD) na Devic disease. Ibaho iyo ubudahangarwa bw'umubiri bugabwe ku turemangingo tw'umubiri. Ibi bibaho cyane cyane mu mugongo no mu mitsi y'amaso ihuza uruhande rw'ijisho n'ubwonko. Ariko rimwe na rimwe bibaho mu bwonko.

Iyi ndwara ishobora kugaragara nyuma y'indwara, cyangwa ishobora guhuzwa n'izindi ndwara ziterwa no kudahangarwa kw'umubiri. Amababi ahinduwe afata kuri poroteyine mu bice by'imitekerereze rukuru kandi akangiza.

Neuromyelitis optica ikunze kwitiranywa na sclerosis nyinshi, izwi kandi nka MS, cyangwa ikaba isa nkaho ari ubwoko bwa MS. Ariko NMO ni indwara itandukanye.

Neuromyelitis optica ishobora gutera ubuhumbu, intege nke mu maguru cyangwa mu maboko, no guhinda umubiri kubabara. Ishobora kandi gutera kubura ubwenge, kuruka no guhinda, ndetse n'ibibazo by'umwijima cyangwa by'amara.

Ibimenyetso bishobora kumera neza hanyuma bikongera kuba bibi, bizwi nko gusubira. Ivura ryo gukumira gusubira ni ingenzi mu gufasha gukumira ubumuga. NMO ishobora gutera ihuma rya burundu no kugorana mu kugenda.

Ibimenyetso bya neuromyelitis optica bifitanye isano n'uburambuye buzaba mu mitsi y'ijisho n'umugongo.

Impinduka z'ububone buterwa na NMO bita optic neuritis. Ibi bishobora kuba:

• Kubura neza kw'ububone cyangwa kubura kw'ububone mu jisho rimwe cyangwa mu yombi.
• Kudashaka kubona ibara.
• Kubabara kw'ijisho.

Ibimenyetso bifitanye isano n'umugongo bita transverse myelitis. Ibi bishobora kuba:

• Gukomera, intege nke cyangwa kubabara mu birenge, rimwe na rimwe no mu biganza.
• Kubura kumva mu biganza cyangwa mu birenge.
• Kudashaka gukura umusemburo cyangwa kugira ikibazo cyo gucunga imikorere y'umusemburo cyangwa ya nyaburanga.
• Kumva nk'aho hari ibintu binyura mu ijosi, mu mugongo cyangwa mu nda.

Ibindi bimenyetso bya NMO bishobora kuba:

• Guhumeka.
• Isesemi no kuruka.

Abana bashobora kugira ikibazo cyo gutekereza, gutakaza ubwenge cyangwa koma. Ariko, ibi bimenyetso mu bana biba byinshi mu ndwara ifitanye isano yitwa myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Ibimenyetso bishobora kugenda neza hanyuma bigaruke. Iyo bigaruka, bita relapse. Relapses ishobora kuba nyuma y'ibyumweru, amezi cyangwa imyaka. Uko igihe gihita, relapses ishobora gutuma umuntu apfa kubona cyangwa apfa kumva, bita paralysis.

Abahanga ntibabizi neza icyateza neuromyelitis optica. Mu bantu barwaye iyi ndwara, ubudahangarwa bw'umubiri bugaba igitero ku mitsi myiza yo mu bwonko. Ubwonko bugizwe n'umugongo, ubwonko n'imitsi y'amaso ihuza uruhande rw'ijisho n'ubwonko. Igitero kibaho kubera ko antikorps zahindutse zifata imyanya iboneka mu bwonko bigatera ibibazo.Iyi réaction y'ubudahangarwa bw'umubiri itera kubyimba, bizwi nko kwishima, kandi bigatera kwangirika kw'uturemangingo tw'imitsi.

Neuromyelitis optica (NMO) ndwara y'akataraboneka. Bimwe mu bintu bishobora kongera ibyago byo kwandura NMO birimo:

• Ibitsina byahawe umuntu ukiri muto. Abagore barwara NMO kenshi kurusha abagabo.
• Imyaka. Akenshi, NMO igaragara mu bantu bakuru. Umuntu ubonetse iyi ndwara afite imyaka 40 y'amavuko. Ariko kandi, abana n'abakuze nabo barayirwara.
• Ubwoko cyangwa ubwoko bw'abantu. Abantu bakomoka muri Hisipaniya, Aziya, Afurika cyangwa Afurika-Karayibe barwara NMO kurusha abazungu.

Ubushakashatsi bumwe bugaragaza ko kutagira vitamine D ihagije mu mubiri, kunywa itabi no kugira ubwandu buke mu buto bishobora kongera ibyago byo kwandura neuromyelitis optica.

Kumenya neuromyelitis optica bisobanura gukora isuzuma ngororamubiri n’ibizamini. Igice cyo gupima harimo no gukuraho izindi ndwara z’imiterere y’ubwonko zifite ibimenyetso bisa. Abaganga nabo bareba ibimenyetso n’ibisubizo by’ibizamini bifitanye isano na NMO. Ibipimo byo gupima neuromyelitis optica spectrum disorder (NMOSD) byatanzwe muri 2015 n’itsinda mpuzamahanga ry’abaganga ba NMO.

Umuhanga mu buvuzi asuzuma amateka yawe y’uburwayi n’ibimenyetso, akakora isuzuma ngororamubiri. Ibindi bizamini birimo:

• Isuzuma ry’imiterere y’ubwonko. Umuganga w’indwara z’imiterere y’ubwonko asuzuma imiterere y’umubiri, imbaraga z’imikaya, uburyo bwo guhuza ibintu, kumva, kwibuka, gutekereza, kubona no kuvuga. Umuganga w’amaso na we ashobora kuba ari mu bazakora isuzuma.
• MRI. Iki kizamini cyo kubona ishusho ikoresha ikirere cya magnetique n’amashanyarazi kugira ngo gikore ishusho igaragaza neza ubwonko, imitsi y’amaso n’umugongo. Ibisubizo bishobora kwerekana ibice byangiritse mu bwonko, imitsi y’amaso cyangwa umugongo.
• Ibizamini by’amaraso. Umuhanga mu buvuzi ashobora gupima amaraso kugira ngo arebe antikorps zifunga kuri poroteyine zikaba intandaro ya NMO. Antikorps ni aquaporin-4-immunoglobulin G, izwi kandi nka AQP4-IgG. Gupima iyi antikorps bishobora gufasha abaganga gutandukanya NMO na MS no gupima NMO hakiri kare.

Ibindi bimenyetso nk’umusemburo wa glial fibrillary acidic protein, uzwi kandi nka GFAP, na serum neurofilament light chain bifasha mu kumenya igihe indwara yongeye kugaruka. Ikizamini cya myelin oligodendrocyte glycoprotein immunoglobulin G antibody, kizwi kandi nka MOG-IgG antibody test, gishobora gukoreshwa mu gushaka izindi ndwara z’umuriro zisa na NMO.

• Gusukura umugufi w’umugongo, bizwi kandi nko gusukura umwimerere w’umugongo. Muri iki kizamini, umuhanga mu buvuzi ashyira igishishwa mu mugongo kugira ngo akuremo utudodo duke tw’amazi yo mu mugongo. Iki kizamini kimenya urwego rw’uturemangingo tw’umubiri, poroteyine na antikorps biri muri ayo mazi. Iki kizamini gishobora gutandukanya NMO na MS.

Amazi yo mu mugongo ashobora kwerekana urwego rwo hejuru cyane rw’uturemangingo tw’amaraso yera mu gihe cy’ibibazo bya NMO. Ibi birenga urwego rusanzwe rugaragara muri MS, nubwo iki kimenyetso atari cyo gihora kibaho.

• Isuzuma ry’uburyo ubwonko bwakiriye ibintu byo kubukangura. Kugira ngo umenye uko ubwonko bwakiriye ibintu byo kubukangura nk’amajwi, amaso cyangwa gukora, ushobora gukora ikizamini cyitwa evoked potentials test cyangwa evoked response test.

Uturango twitwa electrodes dufatwa ku mutwe, rimwe na rimwe, ku matwi, ku ijosi, ku maboko, ku maguru no ku mugongo. Ibikoresho bifatanye na electrodes biyandika uburyo ubwonko bwakiriye ibintu byo kubukangura. Ibi bizamini bifasha mu kubona ibice byangiritse mu mitsi, umugongo, imitsi y’amaso, ubwonko cyangwa brainstem.

• Optical coherence tomography. Iki kizamini kireba urwego rw’imitsi y’amaso n’uburebure bwayo. Abarwayi bafite imitsi y’amaso yanduje ya NMO bagira ibibazo bikomeye byo kubona n’imitsi y’amaso yoroheye kurusha abantu bafite MS.

Ibizamini by’amaraso. Umuhanga mu buvuzi ashobora gupima amaraso kugira ngo arebe antikorps zifunga kuri poroteyine zikaba intandaro ya NMO. Antikorps ni aquaporin-4-immunoglobulin G, izwi kandi nka AQP4-IgG. Gupima iyi antikorps bishobora gufasha abaganga gutandukanya NMO na MS no gupima NMO hakiri kare.

Ibindi bimenyetso nk’umusemburo wa glial fibrillary acidic protein, uzwi kandi nka GFAP, na serum neurofilament light chain bifasha mu kumenya igihe indwara yongeye kugaruka. Ikizamini cya myelin oligodendrocyte glycoprotein immunoglobulin G antibody, kizwi kandi nka MOG-IgG antibody test, gishobora gukoreshwa mu gushaka izindi ndwara z’umuriro zisa na NMO.

Gusukura umugufi w’umugongo, bizwi kandi nko gusukura umwimerere w’umugongo. Muri iki kizamini, umuhanga mu buvuzi ashyira igishishwa mu mugongo kugira ngo akuremo utudodo duke tw’amazi yo mu mugongo. Iki kizamini kimenya urwego rw’uturemangingo tw’umubiri, poroteyine na antikorps biri muri ayo mazi. Iki kizamini gishobora gutandukanya NMO na MS.

Amazi yo mu mugongo ashobora kwerekana urwego rwo hejuru cyane rw’uturemangingo tw’amaraso yera mu gihe cy’ibibazo bya NMO. Ibi birenga urwego rusanzwe rugaragara muri MS, nubwo iki kimenyetso atari cyo gihora kibaho.

Isuzuma ry’uburyo ubwonko bwakiriye ibintu byo kubukangura. Kugira ngo umenye uko ubwonko bwakiriye ibintu byo kubukangura nk’amajwi, amaso cyangwa gukora, ushobora gukora ikizamini cyitwa evoked potentials test cyangwa evoked response test.

Uturango twitwa electrodes dufatwa ku mutwe, rimwe na rimwe, ku matwi, ku ijosi, ku maboko, ku maguru no ku mugongo. Ibikoresho bifatanye na electrodes biyandika uburyo ubwonko bwakiriye ibintu byo kubukangura. Ibi bizamini bifasha mu kubona ibice byangiritse mu mitsi, umugongo, imitsi y’amaso, ubwonko cyangwa brainstem.