NARVE THALO: PERIPHERAL NEUROPATHY

NARVE THALO: PERIPHERAL NEUROPATHY

- Dr. C. Lalnunpuia

Mizote hi kan ram retheih vang te, Ei leh in/zuk leh hmuam kan insum loh vangte, kan damdawi ei huai lutuk vang te, kan natna kan enkawl mail oh vang leh chhan eng eng emaw avangin natna kan ngah em em mai a. Chung zingah chuan hriatna thazam chak lo (a bikin Peripheral Neuropathy) hi a tam ber chu a ni.  Thingtlang lamah a tam zual niin a hriat a, khawpuiah pawh a bang chuang lo. A lo awm chhan te, a enkawlna leh invenna lam te, a thlen theih thil tha lote leh Kan hriat atana tha thil thenkhat chauh kan tarlang ang.

Peripheral Neuropathy chu eng nge ni?

        Kan hriat angin kan taksa peng tin mai hi Hriatna thazam ropui lutukin a thlunzawm chuat mai a. Chu chu hlawm lian pui pui pahniha thenin Central Nervous System leh Peripheral Nervous System tiin an then a. Peripheral Nerve-te chuan taksa hmun hrang hrang atanga an thil hriatte chu thluak/spinal cord-ah thawnin thluak/spinal cord atangin thil tih dan tur pawh taksa hmun tina rang lutukin an keng kual a, Chung hriatna thazam zinga pakhat emaw, a aia tam emaw a khawloh chuan taksa peng hnathawh a buai ta thin a ni. 

Peripheral Neuropathy chi hrangte:

1)      Mononeuropathy : Engemaw avangin hriatna thazam pakhat bik chak lo a awm thin. E.g. carpal tunnel Syndrome, axillary nerve/ulnar nerve/radial nerve/peroneal nerve palsy, etc. A hriatna thazama tihpalh (injury) vang te, thisena chawmtu thisenzam dik lo vang te, hriatna thazama infection/inflammation awm vangte pawhin a awm thei. Computer-a rei tak thil chhu thin zingah te, taksa chak lohna avanga rei tak wheel chair-a thut ngai (continuous and repetitive motion) angah te pawh hian hetiang nerve chak lo hi a awm thei.   

2)       Mononeuritis multicomplex : Hemi hi chu a chunga kan sawi Mononeuropathy ang deuh thova intanin, hun engemaw chen hnuah nerve dang chak lo a lo awm tel ve zel a, a rei deuh hnu phei chuan Polyneuropathy nen pawh thliar hran a har thin. A tlangpuiin a intan dan a rang a, na a awm tel deuh ngei bawk. Zunthlum nei zingah te, Phar (leprosy) leh HIV natna nei zingah te, natna thenkhat (polyarteritis nodosa/Rheumatoid arthritis/ SLE/Amyloidosis, etc) leh damdawi thenkhat vangin a awm duh bik.

3)       Polyneuropathy : Peripheral Neuropathy tam ber hi chu hetiang hi a ni. Peripheral nerve engemaw zat chu engemaw avangin an hnathawh a buai a, Chaw-mawlh (numbness), mu chur chur, khawih leh lum leh vawt pawh hre mang lo, na leh vung tihte thlengin a awm thei. Polyneuropathy zingah hlauhawm ber Guillain-Barre Syndrome thlengin a awm thei a ni. Zunthlum zingah te, Vitamin tlakchham vang te, zu leh damdawi thenkhat vang, etc. tein he natna nei hi Mizo zingah pawh kan tam hle a ni.

4)       Autonomic Neuropathy : Taksa chhung lam organ-te chawmtu hriatna thazam a chak loh chuan kawthalo, ek khal, zun leh ek control thei lo, mipat hmeichhiatna lama hniam, pum na, malabsorption leh BP hniam, etc. tihte a awm ve thei. Rei tak zunthlum lo nei tawhte zingah a tam zual.

5)       Neuritis : Hriatna thazam inflammation hi Neuritis an tih chu a ni mai a.  A hriatna thazam khawih chhiat azirin a lanchhuah dan pawh a inang vek lo. A then chu Na ngawt ngawt ang te, Na zawk zawk/uaih uaih ang te, chak lo leh chaw-mawlh ang te, che hleithei lo angte pawhin a langchhuak thei. A chhan tlangpuite chu : Pheikhawk ke artui sang bun nasat vang te, Infection (Awm vel natna, Phar natna, Lyme’s Disease, etc) vang te,  Zunthlum leh Diphtheria vang te,  Vitamin B1 leh B12 tlakchham vang te, Thyroid natna thenkhat leh cancer vang te, zu leh chhan dang eng eng emaw vangte a ni. Neuritis hi chi hrang hrang (multiple neuritis, Brachial neuritis, optic neuritis, vestibular neuritis, Cranial neuritis/Bell’s Palsy ) a awm leh a. Heng chu sawi thui lo ta ila.

A Chhan Tlangpuite:

Peripheral neuropathy lo awm chhan tlangpui leh kan rama a larzual nia langte kan sawi nual tawh a; heti hian chhinchhiah ila:

1)       Zunthlum : Zunthlum nei zinga zaa 50 hi chuan a lo rei deuh hnuah hriatna thazam tha lo an nei thin niin mithiamte chuan an sawi. Zunthlumin neuropathy a siam theih dan chu sawi thui lo mai ila. Eng emaw chen chu inven theih a ni.

2)       Vitamin tlakchham vang (Vitamin B12, folate)

3)       Zu (Alcohol)

4)       Awmvel natna (post-herpetic neuralgia)

5)       Rheumatoid arthritis leh SLE (autoimmune disease)

6)       HIV

7)       Toxin thenkhat (Rannung thahna hlo, arsenic, lead, mercury, etc)

8)       Cancer leh BP sang/Kaih/cancer/TB damdawi thenkhat (vincristine, metronidazole, phenytoin, nitrofurantoin, isoniazid, etc)

9)       Kal hnathawk tha lo (chronic renal failure)

10)   Inthlahchhawnna atangin

11)   Inhliam vangin

12)   Chhan hriat loh (idiopathic neuropathy)

13)   A dangte

A Lanchhuah Dan Tlangpuite :

Hriatna thazam tha lo hi a awmna hmun azir leh a thlentu azirin lanchhuah dan tam tak a awm thei a, Mizote zinga hetiang neite zinga a lo lanchhuah dan tam berte chu hetiang hi a ni:

1)       Mi tamzawkah chuan kut leh ke a chawmawlh a, khawih leh lum leh vawt hre mang lo khawp pawhin a chawmawlh thei. A mu chur chur a, a hik chur chur maithei bawk. Mi tam berin an insawisel tan dan a ni.

2)       Mi thenkhatah chuan a sa hum hum a, a na ngut ngut bawk. Kut leh ke hmawr te, taksa peng khawi lai emaw chauhte pawh a ni thei. Awmvel natna nei zingah pawh a awmna hmun azirin an sawiselna lai a dang thin.

3)       Kut leh ke chak lo/zawi tihte pawh a awm thin. Mi thenkhat phei chu kawrkilh han kilh that mai pawh harsa an tiin kea tawite an kal pawhin an chauin an ke a kham em em mai thin.

4)       Pum tha lo zingah te,  paitawihna lam sawisel nasaho zingah te,  ek khal leh kawthalo reng mai zingahte hian neuropathy nei an tam mai.

5)       Lung (heart) chawmtu hriatna zam a chak loh chuan thawhphut luhai kan tih ang chi te, nikhaw hre lova tluk maite pawh a awm ve thei. Mizoramah pawh Vitamin tlachham nasaho zingah hian Lung chak lo/lung vung/heart failure hmuh a ni zauh zauh bawk.

6)       Kut leh ke vung : Neuropathy avanga lung chak lo leh thisen zam tha lo zingah an tam zual niin a lang.  An chau sam em em a, thaw-hah, lungphu mumal lo, etc. tihte an insawisel a. Investigation han tih tak tak chuan neuropathy vanga hetiang nei hi an lo tam ve khawp mai. Neuropathy avanga kut/ke vung hi chhan (pathophysiology) dang a awm thei bawk.

7)       Mipat hmeichhiatna kawnga chak lo thlengin a awmtir ve thei. Serh khawng thei lo, chakna tlahniam, serh ro, etc. a awm ve thei tlat bawk.

8)       Engmah ti lo pawha kut leh ke thlan dup dup thinte zingah neuropathy nei an tam mai.

9)       Chauh hluah hluahna te, tihrawl na them thum (muscle cramps), kut leh ke sai hlek hlek (tremor/fasciculation) te,  hriatna thazam chak lo azirin kut/ke khawng, zung thei lo, ek khal/kawtha lo, etc. etc. a awm thei bawk.

10)   A dang dang pawh

Inenkawlna lam :

1)       A chhan a zirin a tih tur pawh a in ang lo. Neuropathy thlentu tihdam hi a tul hmasa ber.

2)       Zunthlum nei chuan control that tur.

3)       Zu-in mi leh zuk leh hmuam ti mi chuan nghei thei se.

4)       Tlakchham nei a nih chuan a tlakchham phuhruk tur ei leh in leh damdawite a tul angin daktawr rawn chunga ei tur

5)       A tul chuan zai (surgery) pawh a ngai mai thei

6)       Pheikhawk bun tur thlan thiam, fimkhur, insawizawi hriselna check-up that leh tihtheih tam tak a awm thei ang

7)       Damdawi ei tur chu a tul dan azirin Doctor rawn chunga ei tur a ni.