Dien nao do Idm sang

DANH CHO BAC SY TRE k.. Dien nao do Idm sang PGS.TS. NguySn ChiMhg Hoi Thdn lanh hoc Viit Nam. Oi$n ndo 66 do Hans Berger (1924) trien khai ghi dien nao d ngudi - Idm sang dien nao dd. I. KHAI NIEM CHUNG Dien nlo do la ghl lai hoat dpng di&n eua nao, thuc hien nhd mot dao ddng k^ die biet nhay elm, cle di^n cue dat d da dIu va the hi&n ra ciing thdi gian vdi nhilu ddng ghi. CIc dong ghl di^n nlo dddc ghi trong mpt thdi gian tuong ddi dai vi hoat ddng dien nao khdng cd nhjp (d dien tim chl edn ghl mpt phdc hpp). Cac noron d nao c6 nhdng nhjp khlc nhau va ddng ghi dupe II ket qui eCia hoat ddng dong bd vi nhCfrig thay doi khdng ddng bp da bj triet ti§u. Hoat ddng dl$n nlo ddac phat trien tren eo sd phdt triln holn chinh myelin, cung nhu ngupe lai qui trinh thoai trien myelin. Dilu niy eho thay tijy tdng Ida tuoi cd nhdng bi^u hien dien ndo do khlc nhau. Do dd, ed hinh Inh dien nlo do binh thudng d tr^ em, d ngudi trudng thinh, cho tdi dien nao do d ngudi eao tudl. Cac loai tdn thuong d nao it nhieu deu ed anh hudng tdi cle qui trinh than kinh, elc hoat dpng <^0n nao. Cae benh cd tdn thuong phu nao nang Inh hudng rat Idn tdi hoat ddng dien ndo. Song song vdi nhOfng hieu biet co ban, hien dai ve cau tao v l chdc ndng he thdn kinh, cle tien bd v6 di$n sinh hpe, nhdng thinh tuu v l vi mach di§n td da II nin mdng eho sUra ddl nhieu the h& mdi eCia mdy ghi diin nao. Websrte: hoithankinhhocvietnam.com.vn. Nghien edu dien nao do d l trdthanh bd phln quan trpng eua sinh ly hpe hien dai, tat cd tham gia ddng gdp nghien edu nao binh thudng v l nlo benh ly. Nghien edu lam sang diin nlo do eung dupe phat trien qua su phdi hc^ chat ehe gida tham khIm lam sang vdi elc tham dd chdc nang khlc, die biet su phoi hpp nghien edu dien nlo vdi sieu am, X quang than kinh, ehup cdt Idp vi tfnh, ehup epng hudng tdtrong chan doln elc rdi loan tuan hoan nlo, u nao d tren leu, d dUdl leu, trong chan doln eac loai benh dpng kinh.. 11. HiNH ANH DIEN NAO D 6 BINH THUtifNG Cd nhieu loai sdng dien nao, va tuy tdc dp di ehuyen eua giay ghi, ta cd nhieu loai sdng khlc nhau. SU phan loai dua tren bi§n dp, tan sd, nhjp dieu, su xuat hien deu d eac ddng ghl dien nlo 1. Cdc song alpha (Berger) Cle sdng alpha cdn gpi II sdng nghi ngdi sinh ly cd nhdng die diem sau: Lien tue deu 20 -100 sdng cho 100 see. Di sdu, edn chia 4 loai sdng alpha. Bien dp sdng alpha thay ddi td 5 - 50mV cho tdi lOOmV.TiJytheo bien dp, suthay ddi eua bien dp nen ed 3 loai sdng alpha. Tan so trung binh td8 -12c/see. S6 13-QUy 111/2015 I THANKINHHOC VIETNAM 125. A DANH CHO BAC SY TRE Phln phdi deu dtoln vd nlo (die diem chinh), Thay doi ve Biin dp nhUng thUdng ro dvung eham - dday sdng alpha Su tang bien dp eua cae sdng len tren 125mV tap trung cao ve tan so, ve bien dp va sudeu khdp. II cd gid hi benh ly- nhat la d ehdng dpng kinh. Kfch thfeh dnh sdng va hoat ddng tdm ly llm Thay doi ve Tdn so ngdng sdng alpha. Thay doi ve Tinh diu khdp 2. Cac song beta (Bremer) Nhdng bat thudng ve dien bien tan sd va Cdc sdng beta cdn gpi la sdng cua hoat dpng nhdng sdng thay ddi keo dli hon 30msee. sinh ly cd nhdng dac diem sau:Tinh lien tue: khd Cdc bat dong thdi dinh gil tdc thi trong khoing cle thoi sdng alpha Cd elc bat ddng thdi, gida ede hoat dpng dien hay khi ed boat ddng sinh ly llm mat nhjp alpha. d cle vung tuong dng d hai ban cau. Bien dp: bien dp eae sdng beta thay doi td Su* vdng cdc song binh thuimg, nhdt Id cdc 15020mV. sdng alpha Tan so nhanh, trong pham vi 17-50c/sec. Tfnh khdng deu, doi lap vdi tinh deu khdp eCia IV. HINH ANH DIEN NAO U6 TRONG NlfiT SO cle sdng alpha. CIc sdng dien d t r i em, eho elc ddng ghi nhjp BENH NAO cham va Idn - tien trien dan tdi nhip binh thudng, Nghiin edu diin nlo dd dng dung vao ehan d ngudi Idn ting dan theo tuoi. Cle dien eham doan lam sang. Ldm sang dien ndo dd - la mpt hoat dpng dien binh thudng trUde tien, cae dien phan khoa ngay eang phat trlen. tran thi sau ciJng. 1. Hinh dnh dien nao d6 trong dong kinh Opng kinh la ehdng benh cd nhilu thay doi III. HINH ANH DIEN NAD DO KHONG BINH rd nhat d dien nao do. Dpng kinh dUpc coi la roi THirfiNG loan nhjp d nao, nghla II rdi loan ed bin eac sdng Cdc sdng delta (sdng Grey vd Walter) dnao. Do la eae sdng eham, tan sd 3 - 5e/sec, cdn Mdt vai rdi loan ed gia trj benh ly: phdc hpp bien dp thi eao hon bien dp eua sdng alpha. nhpn-sdng, cdc nhpn ddn ddc hay nhieu nhpn, Cdc sdng theta Od la eac sdng trung gian gida sdng alpha v l sdng delta ed nhjp td 4 - 7c/sec Thay doi ve hinh thdi Cle sdng ed the thay doi ve hinh ding : nhpn,gai, ring eua. Cdc nhpn ddn ddc ed bien dp Idn hay be. Cd nhieu nhpn (da nhpn). Cd nhieu nhpn song. Phdc hpp nhpn song. Cdc sdng hinh rang cda hay phdc hpp con nho tdm than van dpng.. cdc sdng thanh hinh ring cUa... Ccm Idn'. Con Idn dupe bieu hien mdt nhjp nhanh, tan sd cao 30 cho Isee va ed bien dp 10 -20 lan Idn cac sdng alpha binh thudng. Can nhd: Con nhd bilu hien bdi mpt bien dp Idn, tan sd cham (3e/see) vd ed dang die biit vdi nhpn-sdng. Can nhd tdm thdn vdn dpng: Cle sdng ^en nlo hinh nen rang cda. Thdng thudng, trong ddng kinh, ddng ghi dien nlo cang rd khi tien hdnh (ghi) sau con. SU trd lai nhjp binh thddng ta khd nhanh.. 126 THJiNKINHH0CVIETNAMI56l3-QUyill/2015. Websrte: hoithankinhhocvietna. om vn. DANH CHO BAC SY TRE k.. Muon tao dilu kien phIt hien cae bit thudng, ngudi ta thudng dung elc phuong phap hoat hda hole bang kfch thfch nhu nham mdmat, kfeh thfeh bang dnh sdng, nghiem phIp thd slu. Thd sau (tang thd) gay trang thai kiem do ha pH mlu gay nen gidm CO^ mdu: 6 ngudi binh thudng thd sdu trong ba phut khdng lam thay doi nhjp sdng dien nao. Ngupe lai, d trudng hpp khdng binh thudng, ta thay xuat hien sdng benh ly.. Trong Nhdi mau nao - tie mach se thay doi tuy vj tri ton thuong, ghi sdm gid dau ed phdc hpp nhpn sdng xen ke, gidm hoat dpng diin tilp sau Id nhdng hoat dpng delta ddn hinh, hoat dpng eham.. 4. Dien nao do trong U nao U nlo gay nin nhdng "vCing im ling" gly rdi loan hoat ddng dien d nhdng viJng xung quanh td gan tdi xa. Thdng thudng gay nen cdc sdng delta tda lan thanh dng sao. Cae sdng rat khdng 2. Diin nao do va Sang chan so deu m l dien the eang cao cdn tan so eua chung Dien nlo do giup eho ehan dodn d giai doan thi eang thap, d eac vung ranh gidi eua khoi u ed dau, eho tien lUpng ngay va d ede giai doan sau the ed nhdng kfeh thfch nhpn sdng. (phli ghi theo ddi, so sinh nhieu lan) sdng delta Cd the qua dien ndo, cd the nghien cdu U tren bieu hien dpng kinh sau sang ehan, cdc sdng leu (u bin cau), U dudi llu (u ho sau), u lanh thfnh, delta ddn hinh, cae sdng eham tda lan, giam hoat u Ic tfnh. ddng dien ndo. 5. Dien nao do va cac Viim nhiem 3. Dien nao 66 va Tai bien mach mau nao Cae loai viem nhiem thddng gap la elc viim Trong Chly mau nao la sU thay ddi toan bp mang nao nhat II viem mIng nlo do lao, viim hoat dpng dien nao hoac sdng nhpn hoac sdng ndo, viem nao do tiem ehung - thudng cd bieu theta, hoac sdng delta tda lan khdng phdn dng hien "phan dng phu ne rli rle"vda ed sdng chlm vdi bat ky kfeh thfeh edm gilc, thj gile, thfnh gidc. vda cd bleu hien kfeh thfeh tda lan.. Website' horthanklnhhocvletnam.com.vn. S 6 l 3 - Q u y 111/2015 ITHAHKINHHOCWfTNAIIII 127.