{"id":189465,"date":"2023-02-24T07:59:59","date_gmt":"2023-02-24T06:59:59","guid":{"rendered":"https:\/\/sdk.mk\/?p=189465"},"modified":"2023-02-24T07:59:59","modified_gmt":"2023-02-24T06:59:59","slug":"ju-njoftojme-me-semundjet-e-rralla-semundja-hirayama","status":"publish","type":"post","link":"https:\/\/sdk.mk\/index.php\/maqedonia\/ju-njoftojme-me-semundjet-e-rralla-semundja-hirayama\/","title":{"rendered":"JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: S\u00cbMUNDJA HIRAYAMA"},"content":{"rendered":"<div class=\"f52428582a4b906b2d2e2a7d733c7d27\" data-index=\"7\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<!-- MSP Ads Asynchronous JS Tag - Generated with Revive Adserver v5.4.1 -->\r\n<ins data-revive-zoneid=\"167\" data-revive-id=\"060fdb01f6430ec164d3519234aa4967\"><\/ins>\r\n<script async src=\"\/\/panel.ads.com.mk\/www\/delivery\/asyncjs.php\"><\/script>\n<\/div>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=0NUvLC_rq9U&amp;list=PLPGcigDEy-qgR2zVetKogPsjWUrslN1gR&amp;index=24\" target=\"_blank\" rel=\"noopener noreferrer\"><em><strong>S\u00ebmundja Hirayama\/Morbus Hirayama<\/strong><\/em><\/a><br \/>\nICD G 12.8<br \/>\nPrevalenca: e panjohur<\/p>\n<p>S\u00ebmundja e njohur n\u00eb literatur\u00ebn mjek\u00ebsore si amiotrofia monomelike \u00ebsht\u00eb nj\u00eb entitet i rrall\u00eb neurologjik q\u00eb u p\u00ebrshkrua p\u00ebr her\u00eb t\u00eb par\u00eb nga neurologu japonez Keizo Hirayama n\u00eb vitin 1959. Amiotrofia monomelike \u00ebsht\u00eb nj\u00eb \u00e7\u2019rregullim i rrall\u00eb beninj i neuronit t\u00eb posht\u00ebm motorik. Kjo s\u00ebmundje e rrall\u00eb ka nj\u00eb fillim tin\u00ebzar dhe karakterizohet nga dob\u00ebsia asimetrike dhe atrofia e muskujve t\u00eb gjymtyr\u00ebve t\u00eb sip\u00ebrme. Ky ent ka mbizot\u00ebrim mashkullor, shfaqet gjat\u00eb adoleshenc\u00ebs, n\u00eb nj\u00eb mosh\u00eb mesatare 15 deri n\u00eb 25 vje\u00e7, por nga kjo gjendje nuk p\u00ebrjashtohen edhe femrat. Prevalenca m\u00eb e lart\u00eb v\u00ebrehet n\u00eb popullat\u00ebn aziatike, me p\u00ebrfaq\u00ebsimin m\u00eb t\u00eb lart\u00eb n\u00eb Japoni, Kin\u00eb, Tajvan, Malajzi, Indi, Sri Lanka, por disa raste jan\u00eb raportuar edhe nga Evropa dhe Amerika e Veriut.<\/p>\n<p>S\u00ebmundja Hirayama \u00ebsht\u00eb nj\u00eb amiotrofi e rrall\u00eb, progresive e ngadalt\u00eb, kryesisht me amiotrofi t\u00eb nj\u00ebanshme t\u00eb t\u00eb miturve q\u00eb prek muskujt e inervuar nga qelizat nervore t\u00eb C7, C8 dhe T1. Kjo gjendje shfaqet si rezultat i ngushtimit t\u00eb t\u00eb ashtuquajtur\u00ebs &#8220;qesk\u00eb&#8221; durale n\u00eb pjes\u00ebn cervikale t\u00eb shtyll\u00ebs kurrizore, e cila \u00e7on n\u00eb ndryshime kronike ishemike n\u00eb brir\u00ebt e p\u00ebrparm\u00eb t\u00eb palc\u00ebs kurrizore, ku jan\u00eb t\u00eb vendosura qelizat nervore p\u00ebr kontrollin e muskujve t\u00eb krah\u00ebve. Pavar\u00ebsisht se shfaqet n\u00eb m\u00ebnyr\u00eb sporadike, n\u00eb literatur\u00eb p\u00ebrshkruhen edhe forma familjare, qoft\u00eb si transmetim autosomal-recesiv apo dominant. Etiologjia dhe patogjeneza e plot\u00eb e s\u00ebmundjes ende nuk dihen plot\u00ebsisht. Edhe pse kjo s\u00ebmundje p\u00ebrgjith\u00ebsisht konsiderohet t\u00eb jet\u00eb jo progresive dhe vet\u00ebkufizuese, ajo shkakton paaft\u00ebsi t\u00eb konsiderueshme tek individ\u00ebt e prekur.<\/p>\n<p><strong>Shenjat dhe simptomat:<\/strong><br \/>\nManifestimi klinik paraqitet me atrofi muskulore dhe dob\u00ebsi t\u00eb parakrah\u00ebve dhe duarve, kryesisht n\u00eb nj\u00ebr\u00ebn, por ndonj\u00ebher\u00eb n\u00eb t\u00eb dy gjymtyr\u00ebt e sip\u00ebrme, por pa ndonj\u00eb shqet\u00ebsim shqisor t\u00eb s\u00eb nj\u00ebjt\u00ebs.Pacient\u00ebt zakonisht ankohen p\u00ebr nj\u00eb r\u00ebnie progresive t\u00eb aft\u00ebsive funksionale, zakonisht n\u00eb nj\u00ebr\u00ebn dor\u00eb (i nj\u00ebansh\u00ebm) q\u00eb \u00ebsht\u00eb p\u00ebr shkak t\u00eb forc\u00ebs s\u00eb zvog\u00ebluar dhe shkatht\u00ebsis\u00eb s\u00eb d\u00ebmtuar. Kufizime t\u00eb tilla i shqet\u00ebsojn\u00eb ata n\u00eb kryerjen e aktiviteteve t\u00eb p\u00ebrditshme q\u00eb k\u00ebrkojn\u00eb funksione t\u00eb shk\u00eblqyera motorike si t\u00eb ngr\u00ebnit, t\u00eb shkruarit, t\u00eb veshurit, etj. Pacient\u00ebt me k\u00ebt\u00eb s\u00ebmundje raportojn\u00eb gjithashtu v\u00ebshtir\u00ebsi n\u00eb temperatura t\u00eb ul\u00ebta t\u00eb ftohta q\u00eb p\u00ebrkeq\u00ebsojn\u00eb simptomat e tyre. Tek pacient\u00ebt, t\u00eb ashtuquajturat &#8220;Pareza e ftoht\u00eb&#8221;. Gjegj\u00ebsisht, k\u00ebta pacient\u00eb nuk raportojn\u00eb dhimbje, por raportojn\u00eb lodhje t\u00eb shtuar, ng\u00ebr\u00e7e t\u00eb muskujve, duar t\u00eb ftohta, dridhje t\u00eb parregullta dhe fascikulacione kontraktuese. Progresi \u00ebsht\u00eb i ngadalsh\u00ebm, zakonisht n\u00eb nj\u00eb periudh\u00eb 3-9 vje\u00e7are, e ndjekur nga nd\u00ebrprerja dhe stabilizimi i simptomave. Her\u00eb pas here mund t\u00eb destabilizohet dhe t\u00eb vazhdoj\u00eb t\u00eb p\u00ebrparoj\u00eb pas mosh\u00ebs 40 vje\u00e7are. N\u00eb raste t\u00eb rralla mund t\u00eb p\u00ebrparoj\u00eb n\u00eb gjymtyr\u00ebn e kund\u00ebrt.<\/p>\n<p><strong>Diagnoza:<\/strong><br \/>\nDiagnoza vendoset n\u00eb baz\u00eb t\u00eb nj\u00eb ekzaminimi t\u00eb detajuar klinik dhe analiz\u00ebs s\u00eb simptomave, MRI t\u00eb trurit, elektromiografis\u00eb s\u00eb muskujve, studimeve t\u00eb p\u00ebr\u00e7ueshm\u00ebris\u00eb nervore. B\u00ebhen analiza rutin\u00eb t\u00eb gjakut dhe nga analizat e tjera t\u00eb gjakut ku v\u00ebrehet nj\u00eb rritje e IgE n\u00eb serum, por r\u00ebnd\u00ebsia klinike e k\u00ebtij konstatimi nuk \u00ebsht\u00eb afirmative.<\/p>\n<p><strong>Mjekimi:<\/strong><br \/>\nN\u00eb k\u00ebt\u00eb s\u00ebmundje ekzistojn\u00eb opsione trajtimi konservativ dhe kirurgjik.Trajtimi konservativ p\u00ebrfshin qasje terapeutike t\u00eb lehta dhe joinvazive si mbajtja e t\u00eb ashtuquajtur\u00ebs jak\u00eb cervikale, e cila p\u00ebrfaq\u00ebson linj\u00ebn e par\u00eb t\u00eb trajtimit. Rekomandohet n\u00eb fazat e hershme t\u00eb s\u00ebmundjes sepse zvog\u00eblon p\u00ebrkuljen e qaf\u00ebs. P\u00ebrkulja e zvog\u00ebluar e qaf\u00ebs ndalon ngjeshjen e m\u00ebtejshme t\u00eb palc\u00ebs kurrizore n\u00eb zon\u00ebn e qaf\u00ebs. Rekomandohet q\u00eb jaka e qaf\u00ebs t\u00eb mbahet diku p\u00ebr 3-4 vjet. Gjat\u00eb fizioterapis\u00eb, si pjes\u00eb e trajtimit konzervativ, kryhen ushtrime p\u00ebr forcimin e muskujve t\u00eb krahut t\u00eb prekur, si dhe st\u00ebrvitje p\u00ebr koordinimin e duarve, nd\u00ebrhyrja kirurgjikale rezervohet p\u00ebr rastet e r\u00ebnda t\u00eb s\u00ebmundjes Hirayama, nd\u00ebrsa ashp\u00ebrsia konfirmohet me MRI, ku ka nj\u00eb d\u00ebmtim serioz t\u00eb palc\u00ebs kurrizore. Nj\u00eb nd\u00ebrhyrje e zakonshme kirurgjikale \u00ebsht\u00eb duraplastika me tenda, e cila \u00ebsht\u00eb v\u00ebrtetuar se ka nj\u00eb shkall\u00eb t\u00eb lart\u00eb suksesi dhe nj\u00eb rezultat t\u00eb mir\u00eb.<\/p>\n<p><strong>Prognoza:<\/strong><br \/>\nEdhe pse rrjedha natyrale e s\u00ebmundjes \u00ebsht\u00eb vet\u00ebkufizuese n\u00eb terma afatgjat\u00eb, dob\u00ebsia mund t\u00eb p\u00ebrparoj\u00eb nga 1 muaj n\u00eb 5 vjet. Prognoza e s\u00ebmundjes mendohet t\u00eb jet\u00eb m\u00eb e mir\u00eb se \u00e7\u2019rregullimet e tjera t\u00eb neuroneve motorike, me mbijetes\u00eb m\u00eb t\u00eb gjat\u00eb dhe m\u00eb pak vdekshm\u00ebri. \u00cbsht\u00eb e r\u00ebnd\u00ebsishme t\u00eb theksohet se si pjes\u00eb e trajtimit konzervativ, fillimi n\u00eb koh\u00eb i p\u00ebrdorimit t\u00eb jak\u00ebs s\u00eb qaf\u00ebs tregon efektivitet n\u00eb pothuajse 58% t\u00eb rasteve. Sigurisht, duhet theksuar se simptomat e mbetura mund t\u00eb zgjasin p\u00ebr dekada. \u00cbsht\u00eb vler\u00ebsuar se af\u00ebrsisht 70% e rasteve do t\u00eb ken\u00eb nj\u00eb paaft\u00ebsi t\u00eb leht\u00eb. Nd\u00ebrhyrja e hershme \u00ebsht\u00eb treguar se kufizon p\u00ebrparimin e s\u00ebmundjes dhe minimizon paaft\u00ebsin\u00eb.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>S\u00ebmundja Hirayama\/Morbus Hirayama ICD G 12.8 Prevalenca: e panjohur S\u00ebmundja e njohur n\u00eb literatur\u00ebn mjek\u00ebsore si amiotrofia monomelike \u00ebsht\u00eb nj\u00eb [&hellip;]<\/p>\n","protected":false},"author":24,"featured_media":189466,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"no","inline_featured_image":false},"categories":[3087],"tags":[],"imageURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2023\/02\/24-Morbus-Hirayama-1-650x366.png","thumbURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2023\/02\/24-Morbus-Hirayama-1-250x141.png","categoryNames":["Maqedonia"],"feature_caption":"","subtitle":"","views":"114","source":"\u0421\u043a\u043e\u043f\u0458\u0435, (\u0421\u0410\u041a\u0410\u041c\u0414\u0410\u041a\u0410\u0416\u0410\u041c.\u041c\u041a)","yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v15.0 - 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