{"id":25747,"date":"2023-04-21T20:54:05","date_gmt":"2023-04-21T13:54:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25747"},"modified":"2023-04-21T20:54:05","modified_gmt":"2023-04-21T13:54:05","slug":"tiep-can-chan-doan-va-phan-loai-giat-co","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/tiep-can-chan-doan-va-phan-loai-giat-co\/","title":{"rendered":"Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i gi\u1eadt c\u01a1"},"content":{"rendered":"

Gi\u1eadt c\u01a1 (myoclonus) l\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi nh\u1eefng c\u1eed \u0111\u1ed9ng kh\u00f4ng ch\u1ee7 \u00fd nhanh, ng\u1eafn do s\u1ef1 co c\u01a1 ho\u1eb7c \u1ee9c ch\u1ebf co c\u01a1. Co c\u01a1 g\u00e2y ra gi\u1eadt c\u01a1 d\u01b0\u01a1ng t\u00ednh, trong khi \u1ee9c ch\u1ebf co c\u01a1 g\u00e2y ra gi\u1eadt c\u01a1 \u00e2m t\u00ednh (run v\u1eaby). B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 gi\u1eadt c\u01a1 l\u00e0 \u201cgi\u1eadt\u201d, \u201cl\u1eafc\u201d ho\u1eb7c \u201cco th\u1eaft\u201d. Gi\u1eadt c\u01a1 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, k\u1ebft qu\u1ea3 th\u0103m kh\u00e1m v\u00e0 kh\u1ea3o s\u00e1t \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng v\u00e0 nguy\u00ean nh\u00e2n.<\/strong><\/p>\n

\"giat-co\"
B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 gi\u1eadt c\u01a1 l\u00e0 \u201cgi\u1eadt\u201d, \u201cl\u1eafc\u201d ho\u1eb7c \u201cco th\u1eaft\u201d.<\/figcaption><\/figure>\n

1. D\u1ecbch t\u1ec5 h\u1ecdc gi\u1eadt c\u01a1<\/strong><\/h2>\n

Tr\u1ea1ng th\u00e1i sau thi\u1ebfu oxy n\u00e3o, b\u1ec7nh tho\u00e1i h\u00f3a th\u1ea7n kinh v\u00e0 c\u00e1c h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng kinh l\u00e0 c\u00e1c nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y gi\u1eadt c\u01a1. \u0110\u1ed9c ch\u1ea5t \u2013 chuy\u1ec3n h\u00f3a v\u00e0 thu\u1ed1c l\u00e0 c\u00e1c nguy\u00ean nh\u00e2n r\u1ea5t th\u01b0\u1eddng g\u1eb7p trong m\u00f4i tr\u01b0\u1eddng b\u1ec7nh vi\u1ec7n.<\/p>\n

2. Ph\u00e2n lo\u1ea1i gi\u1eadt c\u01a1 theo l\u00e2m s\u00e0ng v\u00e0 nguy\u00ean nh\u00e2n<\/strong><\/h2>\n

Theo Marsden v\u00e0 c\u1ed9ng s\u1ef1, gi\u1eadt c\u01a1 \u0111\u01b0\u1ee3c chia l\u00e0m 4 nh\u00f3m nguy\u00ean nh\u00e2n ch\u00ednh:
\n\u2013 Sinh l\u00fd
\n\u2013 V\u00f4 c\u0103n
\n\u2013 \u0110\u1ed9ng kinh
\n\u2013 Th\u1ee9 ph\u00e1t (tri\u1ec7u ch\u1ee9ng)<\/p>\n

2.1. Gi\u1eadt c\u01a1 sinh l\u00fd<\/strong><\/h3>\n

Gi\u1eadt c\u01a1 sinh l\u00fd l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng b\u00ecnh th\u01b0\u1eddng \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh, kh\u00f4ng g\u00e2y \u1ea3nh h\u01b0\u1edfng ch\u1ee9c n\u0103ng ho\u1eb7c \u1ea3nh h\u01b0\u1edfng ch\u1ee9c n\u0103ng nh\u1eb9, th\u0103m kh\u00e1m l\u00e2m s\u00e0ng th\u01b0\u1eddng kh\u00f4ng c\u00f3 b\u1ea5t th\u01b0\u1eddng.
\nV\u00ed d\u1ee5 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 gi\u1eadt c\u01a1 l\u00fac ng\u1ee7 ho\u1eb7c l\u00fac s\u1eafp ng\u1ee7.<\/p>\n

2.2. Gi\u1eadt c\u01a1 v\u00f4 c\u0103n<\/strong><\/h3>\n

Trong gi\u1eadt c\u01a1 v\u00f4 c\u0103n, gi\u1eadt c\u01a1 l\u00e0 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng n\u1ed5i b\u1eadt nh\u1ea5t ho\u1eb7c l\u00e0 duy nh\u1ea5t. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 \u1ea3nh h\u01b0\u1edfng ch\u1ee9c n\u0103ng nh\u1eb9. B\u1ec7nh kh\u00f4ng ti\u1ebfn tri\u1ec3n ho\u1eb7c ti\u1ebfn tri\u1ec3n ch\u1eadm. Nh\u1eadn th\u1ee9c kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng.
\nGi\u1eadt c\u01a1 v\u00f4 c\u0103n \u0111\u01b0\u1ee3c chia th\u00e0nh 2 nh\u00f3m: gi\u1eadt c\u01a1 l\u1ebb t\u1ebb v\u00e0 gi\u1eadt c\u01a1 di truy\u1ec1n.<\/p>\n

2.3. Gi\u1eadt c\u01a1 l\u1ebb t\u1ebb: gi\u1eadt c\u01a1 kh\u1ea9u c\u00e1i<\/strong><\/p>\n

Gi\u1eadt c\u01a1 kh\u1ea9u c\u00e1i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 th\u1ee9 ph\u00e1t do t\u1ed5n th\u01b0\u1eddng th\u00e2n n\u00e3o v\u00e0\/ho\u1eb7c ti\u1ec3u n\u00e3o.
\nTuy nhi\u00ean, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea5u tr\u00fac r\u00f5 r\u00e0ng v\u00e0 \u0111\u01b0\u1ee3c xem l\u00e0 gi\u1eadt c\u01a1 kh\u1ea9u c\u00e1i v\u00f4 c\u0103n. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111\u00f3, gi\u1eadt c\u01a1 th\u01b0\u1eddng do co c\u01a1 c\u0103ng m\u00e0n kh\u1ea9u c\u00e1i. Ng\u01b0\u1ee3c l\u1ea1i, gi\u1eadt c\u01a1 kh\u1ea9u c\u00e1i th\u1ee9 ph\u00e1t (tri\u1ec7u ch\u1ee9ng) th\u01b0\u1eddng do co c\u01a1 n\u00e2ng m\u00e0n kh\u1ea9u c\u00e1i. Gi\u1eadt c\u01a1 tai gi\u1eefa c\u00f3 th\u1ec3 l\u00e0 v\u00f4 c\u0103n ho\u1eb7c th\u1ee9 ph\u00e1t v\u00e0 \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 co c\u01a1 c\u0103ng m\u00e0n nh\u0129 v\u00e0\/ho\u1eb7c c\u01a1 b\u00e0n \u0111\u1ea1p. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y s\u1ebd g\u00e2y ra \u00f9 tai ho\u1eb7c ti\u1ebfng click trong tai.<\/p>\n

2.4. Gi\u1eadt c\u01a1 v\u00f4 c\u0103n di truy\u1ec1n<\/strong><\/h3>\n

Gi\u1eadt c\u01a1 v\u00f4 c\u0103n di truy\u1ec1n c\u00f3 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng sau:
\n\u2013 Kh\u1edfi ph\u00e1t tr\u01b0\u1edbc 20 tu\u1ed5i
\n\u2013 Di truy\u1ec1n tr\u1ed9i nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng v\u1edbi \u0111\u1ed9 bi\u1ec3u hi\u1ec7n \u0111a d\u1ea1ng
\n\u2013 Di\u1ec5n ti\u1ebfn l\u00e0nh t\u00ednh v\u1edbi tu\u1ed5i th\u1ecd b\u00ecnh th\u01b0\u1eddng
\n\u2013 Kh\u00f4ng c\u00f3 th\u1ea5t \u0111i\u1ec1u ti\u1ec3u n\u00e3o, co c\u1ee9ng c\u01a1, sa s\u00fat tr\u00ed tu\u1ec7 v\u00e0 c\u01a1n \u0111\u1ed9ng kinh
\nGi\u1eadt c\u01a1 th\u01b0\u1eddng x\u1ea3y ra \u1edf hai chi tr\u00ean v\u00e0 c\u01a1 th\u00e2n tr\u1ee5c, n\u1eb7ng l\u00ean khi v\u1eadn \u0111\u1ed9ng c\u01a1 v\u00e0 gi\u1ea3m \u0111i r\u00f5 r\u1ec7t khi u\u1ed1ng r\u01b0\u1ee3u. Gi\u1eadt c\u01a1 v\u00f4 c\u0103n di truy\u1ec1n c\u00f3 ngu\u1ed3n g\u1ed1c d\u01b0\u1edbi v\u1ecf-kh\u00f4ng khoanh \u0111o\u1ea1n (subcortical-nonsegmental).
\nLo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 l\u00e0 \u0111\u1eb7c \u0111i\u1ec3m th\u01b0\u1eddng th\u1ea5y trong gi\u1eadt c\u01a1 v\u00f4 c\u0103n di truy\u1ec1n v\u00e0 khi xu\u1ea5t hi\u1ec7n c\u00f9ng l\u00fac, t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng gi\u1eadt c\u01a1-lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1. Ngo\u00e0i gi\u1eadt c\u01a1, h\u1ed9i ch\u1ee9ng n\u00e0y c\u00f2n bi\u1ec3u hi\u1ec7n lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 v\u1edbi m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau, nh\u01b0ng th\u01b0\u1eddng l\u00e0 nh\u1eb9, th\u01b0\u1eddng hi\u1ec7n di\u1ec7n \u1edf c\u1ed5 v\u00e0\/ho\u1eb7c chi.<\/p>\n

2.5. Gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh<\/strong><\/h3>\n

Gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh \u00e1m ch\u1ec9 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a gi\u1eadt c\u01a1 trong b\u1ed1i c\u1ea3nh b\u1ec7nh \u0111\u1ed9ng kinh. C\u00e1c c\u01a1n \u0111\u1ed9ng kinh l\u00e0 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng n\u1ed5i b\u1eadt trong gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh. Nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 v\u00f4 c\u0103n, do gen ho\u1eb7c b\u1ec7nh n\u00e3o t\u0129nh tr\u1ea1ng.
\nGi\u1eadt c\u01a1 c\u00f3 th\u1ec3 x\u1ea3y ra nh\u01b0 l\u00e0 m\u1ed9t trong c\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a c\u01a1n \u0111\u1ed9ng kinh, ho\u1eb7c bi\u1ec3u hi\u1ec7n duy nh\u1ea5t c\u1ee7a c\u01a1n \u0111\u1ed9ng kinh (c\u01a1n \u0111\u1ed9ng kinh gi\u1eadt c\u01a1) ho\u1eb7c l\u00e0 m\u1ed9t trong c\u00e1c lo\u1ea1i c\u01a1n \u0111\u1ed9ng kinh c\u1ee7a m\u1ed9t h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng kinh nh\u1ea5t \u0111\u1ecbnh. C\u00e1c lo\u1ea1i gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh kh\u00e1c nhau c\u00f3 th\u1ec3 c\u00f3 ngu\u1ed3n g\u1ed1c sinh l\u00fd v\u1ecf n\u00e3o ho\u1eb7c v\u1ecf n\u00e3o-d\u01b0\u1edbi v\u1ecf.<\/p>\n

2.4. Gi\u1eadt c\u01a1 nguy\u00ean ph\u00e1t<\/strong><\/h3>\n

Gi\u1eadt c\u01a1 \u0111\u01a1n \u0111\u1ed9c g\u1eb7p trong gi\u1eadt c\u01a1 ti\u1ebfn tri\u1ec3n nguy\u00ean ph\u00e1t c\u1ee7a tu\u1ed5i gi\u00e0 v\u00e0 gi\u1eadt c\u01a1 v\u1ecf n\u00e3o gia \u0111\u00ecnh.<\/p>\n

2.5. Gi\u1eadt c\u01a1 tri\u1ec7u ch\u1ee9ng<\/strong><\/h3>\n

Gi\u1eadt c\u01a1 x\u1ea3y ra do r\u1ed1i lo\u1ea1n th\u1ea7n kinh ho\u1eb7c kh\u00f4ng ph\u1ea3i do th\u1ea7n kinh, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 gi\u1eadt c\u01a1 tri\u1ec7u ch\u1ee9ng.
\nGi\u1eadt c\u01a1 tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra b\u1ea5t c\u1ee9 b\u1ec7nh th\u1ea7n kinh n\u00e0o. C\u00e1c nh\u00f3m ch\u00ednh bao g\u1ed3m:
\n\u2013 Do thu\u1ed1c, do \u0111\u1ed9c ch\u1ea5t
\n\u2013 B\u1ec7nh n\u00e3o, bao g\u1ed3m b\u1ec7nh n\u00e3o do thi\u1ebfu oxy
\n\u2013 B\u1ec7nh tho\u00e1i h\u00f3a th\u1ea7n kinh
\n\u2013 T\u1ed5n th\u01b0\u01a1ng khu tr\u00fa h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng
\n\u2013 \u0110\u1ed9ng kinh gi\u1eadt c\u01a1 ti\u1ebfn tri\u1ec3n
\n\u2013 Th\u1ea5t \u0111i\u1ec1u gi\u1eadt c\u01a1 ti\u1ebfn tri\u1ec3n
\n\u2013 Nhi\u1ec5m tr\u00f9ng v\u00e0 h\u1eadu nhi\u1ec5m
\n\u2013 Vi\u00eam t\u1ef1 mi\u1ec5n, bao g\u1ed3m h\u1ed9i ch\u1ee9ng opsoclonus-myoclonus
\n\u2013 R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a.
\n\u2013 R\u1ed1i lo\u1ea1n \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u c\u01a1 quan, bao g\u1ed3m c\u00e1c b\u1ec7nh ti th\u1ec3.
\n\u2013 B\u1ec7nh do r\u1ed1i lo\u1ea1n d\u1ef1 tr\u1eef.
\n\u2013 H\u1ed9i ch\u1ee9ng gi\u1eadt m\u00ecnh qu\u00e1 m\u1ee9c (exaggerated startle syndrome).
\n\u2013 Gi\u1eadt c\u01a1 do t\u00e2m l\u00fd.<\/p>\n

3. Ph\u00e2n lo\u1ea1i gi\u1eadt c\u01a1 d\u1ef1a theo sinh l\u00fd v\u00e0 gi\u1ea3i ph\u1eabu\u00a0<\/strong><\/h2>\n

Ngo\u00e0i ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng v\u00e0 nguy\u00ean nh\u00e2n, gi\u1eadt c\u01a1 c\u00f2n c\u00f3 th\u1ec3 ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean v\u1ecb tr\u00ed c\u1ee7a c\u01a1 ch\u1ebf sinh l\u00fd g\u00e2y ra gi\u1eadt c\u01a1. Nh\u1eefng v\u1ecb tr\u00ed sinh l\u00fd \u2013 gi\u1ea3i ph\u1eabu bao g\u1ed3m:
\n\u2013 V\u1ecf n\u00e3o
\n\u2013 V\u1ecf n\u00e3o \u2013 d\u01b0\u1edbi v\u1ecf
\n\u2013 D\u01b0\u1edbi v\u1ecf \u2013 kh\u00f4ng khoanh \u0111o\u1ea1n
\n\u2013 Khoanh \u0111o\u1ea1n (segmental)
\n\u2013 Ngo\u1ea1i bi\u00ean
\nS\u01a1 \u0111\u1ed3 ph\u00e2n lo\u1ea1i n\u00e0y c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n gi\u1eadt c\u01a1 v\u00e0 h\u01b0\u1edbng d\u1eabn l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t s\u1ed1 lo\u1ea1i gi\u1eadt c\u01a1. C\u00e1ch ph\u00e2n lo\u1ea1i n\u00e0y s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn trong b\u00e0i “Ph\u00e2n lo\u1ea1i gi\u1eadt c\u01a1 d\u1ef1a theo sinh l\u00fd v\u00e0 gi\u1ea3i ph\u1eabu”<\/strong><\/p>\n

T\u00f3m l\u1ea1i, \u0111\u1ed9ng kinh rung gi\u1eadt c\u01a1<\/a> l\u00e0 m\u1ed9t s\u1ef1 co c\u01a1 ng\u1eafn c\u00f3 c\u1ea3m gi\u00e1c nh\u01b0 gi\u1eadt, c\u00f3 th\u1ec3 kh\u00e1c nhau v\u1ec1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng v\u00e0 s\u1ef1 ph\u00e2n b\u1ed1. Gi\u1eadt c\u01a1 c\u00f3 th\u1ec3 l\u00e0 sinh l\u00fd (v\u00ed d\u1ee5, n\u1ea5c, gi\u1eadt c\u01a1 li\u00ean quan \u0111\u1ebfn gi\u1ea5c ng\u1ee7) ho\u1eb7c th\u1ee9 ph\u00e1t sau c\u00e1c b\u1ec7nh l\u00fd n\u00e3o, b\u1ec7nh l\u00fd h\u1ec7 th\u1ed1ng, ho\u1eb7c thu\u1ed1c. N\u1ebfu nguy\u00ean nh\u00e2n l\u00e0 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, c\u1ea7n \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd c\u0103n nguy\u00ean, s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u0111\u1ec3 l\u00e0m gi\u1ea3m tri\u1ec7u ch\u1ee9ng (v\u00ed d\u1ee5 clonazepam, valproate, levetiracetam).<\/p>\n

Ngu\u1ed3n: H\u1ed9i th\u1ea7n kinh h\u1ecdc Vi\u1ec7t Nam<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Gi\u1eadt c\u01a1 (myoclonus) l\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi nh\u1eefng c\u1eed \u0111\u1ed9ng kh\u00f4ng ch\u1ee7 \u00fd nhanh, ng\u1eafn do s\u1ef1 co c\u01a1 ho\u1eb7c \u1ee9c ch\u1ebf co c\u01a1. Co c\u01a1 g\u00e2y ra gi\u1eadt c\u01a1 d\u01b0\u01a1ng t\u00ednh, trong khi \u1ee9c ch\u1ebf co c\u01a1 g\u00e2y ra gi\u1eadt c\u01a1 \u00e2m t\u00ednh (run v\u1eaby). B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 […]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nTi\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i gi\u1eadt c\u01a1 - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110\u1ed9ng kinh rung gi\u1eadt c\u01a1 l\u00e0 m\u1ed9t s\u1ef1 co c\u01a1 tho\u00e1ng qua \u1edf m\u1ed9t ho\u1eb7c m\u1ed9t nh\u00f3m c\u01a1. 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