{"id":25761,"date":"2023-04-21T20:53:51","date_gmt":"2023-04-21T13:53:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25761"},"modified":"2023-04-21T20:53:51","modified_gmt":"2023-04-21T13:53:51","slug":"cac-phuong-phap-khao-sat-giat-co-tren-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/cac-phuong-phap-khao-sat-giat-co-tren-lam-sang\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t gi\u1eadt c\u01a1 tr\u00ean l\u00e2m s\u00e0ng"},"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. C\u00e1c h\u01b0\u1edbng d\u1eabn kh\u1ea3o s\u00e1t m\u1ed9t b\u1ec7nh nh\u00e2n gi\u1eadt c\u01a1 c\u00f3 th\u1ec3 chia l\u00e0m 4 ph\u1ea7n:<\/strong>
\n\u2013 X\u00e1c \u0111\u1ecbnh h\u1ed9i ch\u1ee9ng d\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng.<\/strong>
\n\u2013 C\u1eadn l\u00e2m s\u00e0ng h\u1ed7 tr\u1ee3.<\/strong>
\n\u2013 \u0110i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng<\/strong>
\n\u2013 X\u00e9t nghi\u1ec7m cho c\u00e1c nguy\u00ean nh\u00e2n hi\u1ebfm g\u1eb7p.<\/strong><\/p>\n

1. X\u00e1c \u0111\u1ecbnh h\u1ed9i ch\u1ee9ng<\/strong><\/h2>\n

B\u01b0\u1edbc \u0111\u1ea7u ti\u00ean \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n gi\u1eadt c\u01a1 l\u00e0 khai th\u00e1c b\u1ec7nh s\u1eed v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng.
\nCh\u1ea9n \u0111o\u00e1n d\u1ec5 d\u00e0ng h\u1ea7u h\u1ebft gi\u1eadt c\u01a1 d\u1ef1a tr\u00ean quan s\u00e1t l\u00e2m s\u00e0ng. Th\u0103m kh\u00e1m b\u1ec7nh nh\u00e2n gi\u1eadt c\u01a1 c\u1ea7n ch\u00fa \u00fd s\u1ef1 ph\u00e2n b\u1ed1, di\u1ec5n ti\u1ebfn theo th\u1eddi gian v\u00e0 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m ho\u1ea1t h\u00f3a.
\n\u2013 Ph\u00e2n b\u1ed1 c\u00f3 th\u1ec3 c\u1ee5c b\u1ed9, nhi\u1ec1u \u1ed5, khoanh \u0111o\u1ea1n ho\u1eb7c to\u00e0n th\u1ec3. Ph\u00e2n b\u1ed1 nhi\u1ec1u \u1ed5 c\u00f3 th\u1ec3 c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e0 c\u00e1c v\u1eadn \u0111\u1ed9ng \u0111\u1ed3ng b\u1ed9 hai b\u00ean c\u01a1 th\u1ec3.
\n\u2013 Di\u1ec5n ti\u1ebfn theo th\u1eddi gian c\u00f3 th\u1ec3 li\u00ean t\u1ee5c ho\u1eb7c t\u1eebng l\u00fac, c\u1eed \u0111\u1ed9ng c\u00f3 th\u1ec3 th\u00e0nh nh\u1ecbp ho\u1eb7c kh\u00f4ng \u0111\u1ec1u. Gi\u1eadt c\u01a1 t\u1eebng l\u00fac c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c th\u00e0nh chu\u1ed7i l\u1eb7p l\u1ea1i.
\n\u2013 S\u1ef1 ho\u1ea1t h\u00f3a gi\u1eadt c\u01a1 c\u00f3 th\u1ec3 l\u00fac ngh\u1ec9 (t\u1ef1 ph\u00e1t), do c\u00f3 k\u00edch th\u00edch kh\u00e1c nhau (gi\u1eadt c\u01a1 ph\u1ea3n x\u1ea1), do v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u00fd (gi\u1eadt c\u01a1 do v\u1eadn \u0111\u1ed9ng), ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00e1c y\u1ebfu t\u1ed1 tr\u00ean. T\u1ea5t c\u1ea3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m ho\u1ea1t h\u00f3a gi\u1eadt c\u01a1 n\u00ean \u0111\u01b0\u1ee3c ghi ch\u00fa l\u1ea1i, d\u00f9 c\u00f3 hay kh\u00f4ng.
\n\u0110\u00f4i khi, quan s\u00e1t b\u1eb1ng m\u1eaft r\u1ea5t kh\u00f3 \u0111\u1ec3 ph\u00e2n bi\u1ec7t gi\u1eadt c\u01a1 v\u1edbi c\u00e1c v\u1eadn \u0111\u1ed9ng kh\u00f4ng ch\u1ee7 \u00fd kh\u00e1c (m\u00faa gi\u1eadt, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1, run). Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng s\u1ebd \u0111\u1eb7c bi\u1ec7t c\u00f3 \u00edch.
\nGi\u1eadt c\u01a1 do thu\u1ed1c ho\u1eb7c \u0111\u1ed9c ch\u1ea5t th\u00ec c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c, v\u00ec trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n h\u00ecnh, gi\u1eadt c\u01a1 s\u1ebd h\u1ebft khi ng\u01b0ng thu\u1ed1c. C\u1ea7n xem x\u00e9t k\u0129 l\u01b0\u1ee1ng t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c, k\u1ec3 c\u1ea3 khi d\u00f9ng \u0111\u01a1n \u0111\u1ed9c hay ph\u1ed1i h\u1ee3p, khi \u0111\u00e1nh gi\u00e1 c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 g\u00e2y gi\u1eadt c\u01a1.<\/p>\n

2. X\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 kh\u1ea3o s\u00e1t gi\u1eadt c\u01a1<\/strong><\/h2>\n

N\u00ean th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 khi nguy\u00ean nh\u00e2n gi\u1eadt c\u01a1 v\u1eabn ch\u01b0a r\u00f5 d\u00f9 \u0111\u00e3 khai th\u00e1c b\u1ec7nh s\u1eed v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng. C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb:
\n\u2013 \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 (bao g\u1ed3m calci, magie).
\n\u2013 Bismuth.
\n\u2013 Glucose.
\n\u2013 Ch\u1ee9c n\u0103ng th\u1eadn.
\n\u2013 Ch\u1ee9c n\u0103ng gan.
\n\u2013 Kh\u00e1ng th\u1ec3 tuy\u1ebfn gi\u00e1p v\u00e0 ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p.
\n\u2013 Kh\u00e1ng th\u1ec3 c\u1eadn ung (b\u1ed9 x\u00e9t nghi\u1ec7m \u0111\u1ea7y \u0111\u1ee7).
\n\u2013 N\u1ed3ng \u0111\u1ed9 vitamin E.
\n\u2013 S\u00e0ng l\u1ecdc thu\u1ed1c v\u00e0 \u0111\u1ed9c ch\u1ea5t n\u1ebfu l\u00e2m s\u00e0ng nghi ng\u1edd s\u1eed d\u1ee5ng thu\u1ed1c kh\u00f4ng r\u00f5 ho\u1eb7c d\u00f9ng c\u00e1c ch\u1ea5t kh\u00f4ng h\u1ee3p ph\u00e1p ho\u1eb7c thu\u1ed1c h\u01b0\u1edbng th\u1ea7n.
\n\u2013 \u0110i\u1ec7n n\u00e3o \u0111\u1ed3.
\n\u2013 H\u00ecnh \u1ea3nh h\u1ecdc n\u00e3o b\u1ed9.
\n\u2013 H\u00ecnh \u1ea3nh h\u1ecdc t\u1ee7y s\u1ed1ng (n\u1ebfu gi\u1eadt c\u01a1 c\u1ee5c b\u1ed9 ho\u1eb7c gi\u1eadt c\u01a1 khoanh \u0111o\u1ea1n).
\n\u2013 Bilan nhi\u1ec5m tr\u00f9ng (t\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u, t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u, c\u1ea5y m\u00e1u, ch\u1ecdc d\u1ecbch n\u00e3o t\u1ee7y, X quang ph\u1ed5i) n\u1ebfu c\u00f3 d\u1ea5u \u0111\u1ecbnh v\u1ecb nh\u01b0 s\u1ed1t, t\u0103ng b\u1ea1ch c\u1ea7u, ho\u1eb7c b\u1ec7nh n\u00e3o.
\n\u2013 Ph\u00e2n t\u00edch d\u1ecbch n\u00e3o t\u1ee7y trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh n\u00e3o, d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec5m tr\u00f9ng, nghi ng\u1edd b\u1ec7nh do r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch ho\u1eb7c b\u1ec7nh do prion (v\u00ed d\u1ee5: CJD).
\nNh\u1eefng x\u00e9t nghi\u1ec7m n\u00e0y bao tr\u00f9m c\u00e1c nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a gi\u1eadt c\u01a1 do r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a m\u1eafc ph\u1ea3i. H\u00ecnh \u1ea3nh h\u1ecdc n\u00e3o b\u1ed9 v\u00e0 t\u1ee7y s\u1ed1ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c teo n\u00e3o t\u1ee7y, gi\u00fap cho ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n \u0111\u1eb7c hi\u1ec7u c\u1ee7a gi\u1eadt c\u01a1. X\u00e9t nghi\u1ec7m d\u1ecbch n\u00e3o t\u1ee7y gi\u00fap ph\u00e2n bi\u1ec7t c\u00e1c nguy\u00ean nh\u00e2n nhi\u1ec5m tr\u00f9ng, vi\u00eam v\u1edbi \u0111\u1ed9c ch\u1ea5t, do thu\u1ed1c ho\u1eb7c chuy\u1ec3n h\u00f3a.
\n\u0110i\u1ec7n n\u00e3o \u0111\u1ed3 gi\u00fap x\u00e1c \u0111\u1ecbnh c\u00e1c ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n n\u00e3o trong c\u01a1n ho\u1eb7c gi\u1eefa c\u00e1c c\u01a1n trong nh\u00f3m gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh. V\u00ed d\u1ee5 nh\u01b0 c\u00e1c gai to\u00e0n th\u1ec3 v\u00e0 ph\u1ee9c h\u1ee3p gai\u2013s\u00f3ng t\u1ea7n s\u1ed1 3-6 Hz l\u00e0 \u0111\u1eb7c tr\u01b0ng c\u1ee7a gi\u1eadt c\u01a1 \u0111\u1ed9ng kinh to\u00e0n th\u1ec3 nguy\u00ean ph\u00e1t, trong khi ph\u1ee9c h\u1ee3p gai\u2013s\u00f3ng t\u1ea7n s\u1ed1 3 Hz g\u1eb7p trong \u0111\u1ed9ng kinh v\u1eafng \u00fd th\u1ee9c.<\/p>\n

3. \u0110i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng<\/strong><\/h2>\n
\"ghi-dien-co\"
Ghi \u0111i\u1ec7n c\u01a1 trong l\u00e2m s\u00e0ng th\u1ea7n kinh<\/figcaption><\/figure>\n

\u0110i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng gi\u00fap ph\u00e2n lo\u1ea1i sinh l\u00fd gi\u1eadt c\u01a1 v\u00e0 h\u1ed7 tr\u1ee3 \u0111\u1ecbnh khu gi\u1ea3i ph\u1eabu th\u1ea7n kinh c\u0169ng nh\u01b0 nguy\u00ean nh\u00e2n. Ngo\u00e0i ra, x\u00e9t nghi\u1ec7m n\u00e0y c\u00f2n gi\u00fap \u00edch khi quan s\u00e1t l\u00e2m s\u00e0ng \u0111\u01a1n thu\u1ea7n kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c gi\u1eadt c\u01a1 v\u1edbi c\u00e1c lo\u1ea1i v\u1eadn \u0111\u1ed9ng kh\u00f4ng ch\u1ee7 \u00fd kh\u00e1c nh\u01b0 m\u00faa gi\u1eadt, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 v\u00e0 run.
\nC\u00e1c k\u1ef9 thu\u1eadt \u0111a k\u00ed<\/em> \u0111\u1ec3 ph\u00e2n lo\u1ea1i sinh l\u00fd gi\u1eadt c\u01a1 bao g\u1ed3m:
\n\u2013 \u0110i\u1ec7n c\u01a1 b\u1ec1 m\u1eb7t<\/strong> (surface electromyography).
\n\u2013 \u0110a k\u00ed \u0111i\u1ec7n n\u00e3o \u0111\u1ed3-\u0111i\u1ec7n c\u01a1 \u0111\u1ed3 \u0111\u1ed3ng th\u1eddi<\/strong> (simultaneous EEG-EMG polygraphy).
\n\u2013 \u0110i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3.<\/strong>
\n\u2013 K\u0129 thu\u1eadt trung b\u00ecnh h\u00f3a ng\u01b0\u1ee3c ho\u1ea1t \u0111\u1ed9ng EEG tho\u00e1ng qua, c\u1ed1 \u0111\u1ecbnh theo gi\u1eadt c\u01a1<\/strong> (Jerk\u2013locked back\u2013averaging of EEG transient) v\u00e0\/ho\u1eb7c \u0111o \u0111i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 theo ph\u00f3ng \u0111i\u1ec7n EMG.
\n\u2013 \u0110\u00e1p \u1ee9ng EMG ti\u1ec1m th\u1eddi d\u00e0i v\u1edbi k\u00edch th\u00edch th\u1ea7n kinh ngo\u1ea1i bi\u00ean<\/strong> (long latency EMG responses to peripheral nerve stimulation), v\u00ed d\u1ee5: ph\u1ea3n x\u1ea1 C.<\/p>\n

X\u00e9t nghi\u1ec7m \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh n\u1ebfu nh\u01b0 ch\u1ea9n \u0111o\u00e1n v\u1eabn kh\u00f4ng r\u00f5 r\u00e0ng sau khi khai th\u00e1c b\u1ec7nh s\u1eed, th\u0103m kh\u00e1m v\u00e0 l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 kh\u00e1c.<\/p>\n

\u0110\u1eb7c \u0111i\u1ec3m \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh c\u1ee7a gi\u1eadt c\u01a1 theo ph\u00e2n lo\u1ea1i gi\u1ea3i ph\u1eabu \u2013 sinh l\u00fd:<\/em><\/p>\n

\u2013 V\u1ecf n\u00e3o:<\/strong> gi\u1eadt c\u01a1 v\u1ecf n\u00e3o x\u1ea3y ra do s\u1ef1 ph\u00f3ng \u0111i\u1ec7n c\u1ee5c b\u1ed9 \u1edf v\u1ecf n\u00e3o c\u1ea3m gi\u00e1c \u2013 v\u1eadn \u0111\u1ed9ng nguy\u00ean ph\u00e1t. Th\u1eddi kho\u1ea3ng ph\u00f3ng \u0111i\u1ec7n EMG \u0111i\u1ec3n h\u00ecnh <75 ms v\u00e0 c\u00f3 ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n n\u00e3o khu tr\u00fa tho\u00e1ng qua khi l\u00e0m k\u1ef9 thu\u1eadt trung b\u00ecnh h\u00f3a ng\u01b0\u1ee3c. \u0110i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 kh\u1ed5ng l\u1ed3 v\u00e0 \u0111\u00e1p \u1ee9ng EMG ti\u1ec1m th\u1eddi d\u00e0i t\u0103ng l\u00ean (v\u00ed d\u1ee5: ph\u1ea3n x\u1ea1 C) l\u00e0 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a gi\u1eadt c\u01a1 v\u1ecf n\u00e3o ph\u1ea3n x\u1ea1.
\n\u2013 V\u1ecf n\u00e3o \u2013 d\u01b0\u1edbi v\u1ecf:<\/strong> sinh l\u00fd gi\u1eadt c\u01a1 v\u1ecf n\u00e3o \u2013 d\u01b0\u1edbi v\u1ecf bao g\u1ed3m c\u00e1c dao \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng, k\u1ecbch ph\u00e1t, qu\u00e1 m\u1ee9c trong c\u00e1c k\u1ebft n\u1ed1i hai chi\u1ec1u gi\u1eefa c\u00e1c v\u1ecb tr\u00ed v\u1ecf n\u00e3o v\u00e0 d\u01b0\u1edbi v\u1ecf. Tr\u00ean \u0111i\u1ec7n c\u01a1 b\u1ec1 m\u1eb7t, th\u1eddi kho\u1ea3ng ph\u00f3ng \u0111i\u1ec7n \u0111i\u1ec3n h\u00ecnh l\u00e0 <100 ms v\u00e0 c\u00e1c h\u00ecnh \u1ea3nh \u0111i\u1ec7n n\u00e3o tho\u00e1ng qua (v\u00ed d\u1ee5: ph\u1ee9c h\u1ee3p gai-s\u00f3ng) th\u01b0\u1eddng lan t\u1ecfa. B\u1eb1ng k\u1ef9 thu\u1eadt trung b\u00ecnh h\u00f3a ng\u01b0\u1ee3c, trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n h\u00ecnh s\u1ebd th\u1ea5y ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n n\u00e3o tho\u00e1ng qua t\u01b0\u01a1ng \u1ee9ng v\u1edbi ph\u00f3ng \u0111i\u1ec7n tr\u00ean \u0111i\u1ec7n c\u01a1. \u0110\u00f4i khi c\u00f3 th\u1ec3 c\u00f3 \u0111i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 kh\u1ed5ng l\u1ed3 v\u00e0 gia t\u0103ng ph\u1ea3n x\u1ea1 ti\u1ec1m th\u1eddi d\u00e0i.
\n\u2013 D\u01b0\u1edbi v\u1ecf – kh\u00f4ng khoanh \u0111o\u1ea1n<\/strong>: gi\u1eadt c\u01a1 d\u01b0\u1edbi v\u1ecf-kh\u00f4ng khoanh \u0111o\u1ea1n c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb d\u01b0\u1edbi v\u1ecf nh\u01b0ng kh\u00f4ng ph\u1ea3i l\u00e0 khoanh \u0111o\u1ea1n (v\u00ed d\u1ee5: h\u1ed9i ch\u1ee9ng gi\u1eadt c\u01a1-lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1). Th\u1eddi kho\u1ea3ng ph\u00f3ng \u0111i\u1ec7n tr\u00ean \u0111i\u1ec7n c\u01a1 thay \u0111\u1ed5i. K\u1ef9 thu\u1eadt trung b\u00ecnh h\u00f3a ng\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh theo gi\u1eadt c\u01a1 kh\u00f4ng cho th\u1ea5y ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n n\u00e3o tho\u00e1ng qua t\u01b0\u01a1ng \u1ee9ng v\u1edbi ph\u00f3ng \u0111i\u1ec7n tr\u00ean \u0111i\u1ec7n c\u01a1. \u0110i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 b\u00ecnh th\u01b0\u1eddng. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 \u0111\u00e1p \u1ee9ng ph\u1ea3n x\u1ea1 EMG v\u1edbi k\u00edch th\u00edch \u00e2m thanh.
\n\u2013 Khoanh \u0111o\u1ea1n:<\/strong> gi\u1eadt c\u01a1 khoanh \u0111o\u1ea1n c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb m\u1ed9t khoanh \u0111o\u1ea1n nh\u1ea5t \u0111\u1ecbnh ho\u1eb7c c\u00e1c khoanh \u0111o\u1ea1n li\u00ean ti\u1ebfp c\u1ee7a th\u00e2n n\u00e3o v\u00e0\/ho\u1eb7c t\u1ee7y s\u1ed1ng. Th\u1eddi kho\u1ea3ng ph\u00f3ng \u0111i\u1ec7n tr\u00ean EMG th\u01b0\u1eddng k\u00e9o d\u00e0i > 100 ms v\u00e0 th\u01b0\u1eddng th\u00e0nh nh\u1ecbp. V\u1edbi test ph\u1ea3n x\u1ea1 EMG, m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p gi\u1eadt c\u01a1 khoanh \u0111o\u1ea1n c\u00f3 \u0111\u00e1p \u1ee9ng ti\u1ec1m th\u1eddi r\u1ea5t ng\u1eafn, kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi ngu\u1ed3n g\u1ed1c tr\u00ean t\u1ee7y s\u1ed1ng.
\n\u2013 Ngo\u1ea1i bi\u00ean:<\/strong> gi\u1eadt c\u01a1 ngo\u1ea1i bi\u00ean c\u00f3 ngu\u1ed3n g\u1ed1c ngo\u1ea1i bi\u00ean (ngh\u0129a l\u00e0 d\u00e2y th\u1ea7n kinh ngo\u1ea1i bi\u00ean). Th\u1eddi kho\u1ea3ng ph\u00f3ng \u0111i\u1ec7n EMG thay \u0111\u1ed5i v\u00e0 kh\u00f4ng \u0111\u1ec1u.<\/p>\n

4. X\u00e9t nghi\u1ec7m kh\u1ea3o s\u00e1t c\u00e1c nguy\u00ean nh\u00e2n hi\u1ebfm c\u1ee7a gi\u1eadt c\u01a1:<\/strong><\/h2>\n

Xem x\u00e9t l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m n\u00e0y n\u1ebfu nh\u01b0 c\u00e1c kh\u1ea3o s\u00e1t ti\u00eau chu\u1ea9n bao g\u1ed3m c\u1ea3 kh\u1ea3o s\u00e1t \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng v\u1eabn kh\u00f4ng t\u00ecm \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n. V\u00ed d\u1ee5 nh\u01b0:
\n\u2013 X\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh h\u1ecdc to\u00e0n c\u01a1 th\u1ec3 \u0111\u1ec3 t\u00ecm ung th\u01b0 \u1ea9n, th\u1eadm ch\u00ed trong tr\u01b0\u1eddng h\u1ee3p c\u00e1c kh\u00e1ng th\u1ec3 c\u1eadn ung th\u01b0 \u0111\u1ec1u \u00e2m t\u00ednh.
\n\u2013 X\u00e9t nghi\u1ec7m enzyme t\u00ecm c\u00e1c b\u1ec7nh thi\u1ebfu h\u1ee5t men neuraminidase v\u00e0 biotinidase.
\n\u2013 X\u00e9t nghi\u1ec7m b\u1ec7nh Wilson<\/a>.
\n\u2013 X\u00e9t nghi\u1ec7m gen (v\u00e0 sinh thi\u1ebft m\u00f4 n\u1ebfu c\u1ea7n) v\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n di truy\u1ec1n, nh\u01b0 b\u1ec7nh Unverricht-Lundborg (gen EMP1), b\u1ec7nh th\u1ec3 Lafora (EMP2A v\u00e0 EMP2B), b\u1ec7nh Huntington v\u00e0 b\u1ec7nh t\u00edch t\u1ee5 ceroid lipofuscin \u1edf h\u1ec7 th\u1ea7n kinh.
\n\u2013 Kh\u1ea3o s\u00e1t b\u1ec7nh ti th\u1ec3, bao g\u1ed3m lactat m\u00e1u, sinh thi\u1ebft c\u01a1, x\u00e9t nghi\u1ec7m gen.<\/p>\n

\"hau-qua-benh-Wilson\"
B\u1ec7nh Wilson l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh di truy\u1ec1n do \u0111\u1ed9t bi\u1ebfn gen l\u1eb7n tr\u00ean nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng<\/figcaption><\/figure>\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. C\u00e1c h\u01b0\u1edbng d\u1eabn kh\u1ea3o s\u00e1t m\u1ed9t b\u1ec7nh nh\u00e2n gi\u1eadt c\u01a1 c\u00f3 th\u1ec3 chia l\u00e0m 4 ph\u1ea7n: \u2013 X\u00e1c \u0111\u1ecbnh h\u1ed9i ch\u1ee9ng d\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng. […]<\/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":"\nC\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t gi\u1eadt c\u01a1 tr\u00ean l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"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. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t gi\u1eadt c\u01a1 tr\u00ean l\u00e2m s\u00e0ng\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t gi\u1eadt c\u01a1 tr\u00ean l\u00e2m s\u00e0ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"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. 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