2025 Movement Disorders Clinical Practice Kev Tshuaj Xyuas Xyoo
Qhov kev hem thawj ntawm subacute sclerosing panencephalitis: Kev hu rau kev nqis tes ua

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Kab mob qhua pias, ua los ntawm Kab mob Morbillivirus Tus kab mob qhua pias (MeV), tam sim no tab tom nce ntxiv thoob ntiaj teb, nrog rau kev nce ntxiv ntau heev hauv xyoo 2024-2025 thoob plaws ntau thaj chaw, suav nrog Tebchaws Meskas, Tebchaws Europe, Canada thiab Mexico.¹ Kab mob qhua pias subacute sclerosing panencephalitis (SSPE) yog ib qho ntawm cov teeb meem loj tshaj plaws uas tshwm sim ntev ntev ntawm tus kab mob qhua pias, uas tshwm sim tom qab nruab nrab latency ntawm 7-10 xyoo tom qab tus kab mob qhua pias. Txawm hais tias tus nqi rov zoo li qub txog li 6% tau tshaj tawm, SSPE feem ntau yog qhov tsis tuaj yeem ua rau mob hnyav thiab thaum kawg tuag taus. Qhov tsis txaus ntawm kev txhaj tshuaj tiv thaiv kab mob tsis yog tsuas yog ua rau muaj kev sib kis ntawm tus kab mob qhua pias xwb, tab sis kuj tseem muaj kev pheej hmoo ntawm cov neeg mob SSPE qeeb hauv xyoo tom ntej. SSPE tshwm sim los ntawm kev nyob ntev ntawm MeV hloov pauv hauv lub hlwb, ua rau raug mob neuronal thiab o.  

SSPE cuam tshuam rau cov menyuam yaus thiab cov hluas, txawm hais tias cov neeg laus pib muaj ntau zuj zus. Nws yog tus cwj pwm los ntawm kev sib sau ua ke ntawm kev cuam tshuam ntawm kev coj cwj pwm tsis zoo, kev pom tsis meej, qaug dab peg, thiab kev txav mus los tsis zoo. Kev kuaj mob vam khom kev sib xyaw ua ke ntawm cov qauv kho mob thiab kev kuaj hauv chaw kuaj mob.^2,3 Qhov tseem ceeb tshaj plaws hauv kev kuaj mob yog qhov muaj cov teeb meem loj, ntev, thiab dav dav ntawm lub electroencephalography, hu ua Radermecker discharges, nrog rau cov serum thiab cerebrospinal fluid anti-measles titers siab. Feem ntau qhov mob no nce ntxiv tas li, ua rau tuag. Tam sim no, tsis muaj kev kho mob zoo, thiab kev kho mob tsuas yog siv kev kho mob uas tsom mus rau cov tsos mob ua ke nrog kev kho mob antiviral thiab/lossis kev kho mob immunomodulatory, uas feem ntau tsis muaj txiaj ntsig zoo rau kev tiv thaiv kab mob kom tsis txhob loj hlob.⁴ Ib qho kev tshuaj xyuas tsis ntev los no tau luam tawm hauv Movement Disorders Clinical Practice (MDCP) phau ntawv xov xwm thiab tau txais txiaj ntsig "2025 Review Article of the Year" hauv MDCP piav qhia txog cov yam ntxwv tseem ceeb, pathophysiology, kev kho mob thiab cov txiaj ntsig ntawm kev txav mus los hauv SSPE.⁵ Cov haujlwm, ua nyob rau hauv kev saib xyuas ntawm MDS Infection-Related Movement Disorders Study Group, lub hom phiaj yog kom nce kev paub thiab txhim kho kev paub ntxov ntawm SSPE ntawm cov kws tshwj xeeb txog kev txav mus los. 

Kev tsis txav mus los tau pom muaj nyob rau hauv feem ntau ntawm cov neeg mob uas muaj SSPE, xws li 1.6-56% ntawm cov neeg mob. Qhov nthuav yog, kev tsis txav mus los yuav tshwm sim hauv txhua theem ntawm tus kab mob thiab qee zaum yog qhov tshwm sim. Cov no suav nrog ataxia, hyperkinetic (myoclonus, dystonia, chorea, tics, stereotypies, kev coj cwj pwm rov ua dua, qhov muag txav tsis zoo) thiab hypokinetic (parkinsonism, akinetic-rigid states). Kev hloov pauv ntawm lub sijhawm ntawm cov tsos mob ntawm lub cev no feem ntau ua rau muaj kev nce qib ntawm tus kab mob, nrog rau ataxia, chorea, thiab dystonia tswj hwm theem thaum ntxov, thiab parkinsonism tshwm sim tom qab, thaum kawg culminating hauv preterminal akinetic-rigid state.  

Qhov kev txav tsis zoo tshaj plaws, suav tias yog lub cim ntawm SSPE, yog myoclonus. Myoclonus, pom nyob rau hauv 84-92% ntawm cov neeg mob, muaj ib qho phenomenology tshwj xeeb, uas yog tus cwj pwm los ntawm theem pib sai sai ua raws li kev so qeeb. Vim nws cov yam ntxwv tshwj xeeb, cov lus piav qhia xws li 'dystonic' myoclonus, 'hung-up' myoclonus, thiab pseudomyoclonus tau siv. Tseeb tiag, qhov chaw tsim tawm ntawm myoclonus hauv SSPE tseem yog ib qho teeb meem ntawm kev sib cav, nrog cov kws kho mob epileptologists sib cav sib ceg txog qhov keeb kwm cortical epileptic (supportrestrained los ntawm nws lub sijhawm-xauv nrog EEG tso tawm thiab ntau zaus teb rau cov tshuaj tiv thaiv myoclonus antiseizure) thiab cov kws tshwj xeeb txog kev txav mus los nyiam qhov keeb kwm subcortical vim nws qeeb so kawg-theem. Lwm qhov kev txav mus los feem ntau yog dystonia, uas tuaj yeem nce mus rau hauv status dystonicus. Txawm hais tias muaj cov yam ntxwv zoo hauv kev kho mob, kev sib raug zoo radiological tseem tsis meej, nrog rau cov MRI ib txwm muaj feem ntau tsis qhia txog kev txav mus los-cov qhov txhab tshwj xeeb. 

Zoo hmoo, SSPE yog ib qho kab mob uas tiv thaiv tau los ntawm kev txhaj tshuaj. Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) txhawb kom txhaj ob koob tshuaj tiv thaiv kab mob qhua pias rau cov menyuam yaus, vim tias ib koob tshuaj xwb yuav tsis muab kev tiv thaiv kab mob mus tas li.⁶ Qhov kev sib raug zoo ntawm kev txhaj tshuaj tiv thaiv kab mob thiab cov teebmeem ncaj qha rau kev txo qis ntawm tus kab mob qhua pias thiab qhov tshwm sim ntawm SSPE yog qhov tau tsim muaj kev sib kis zoo.⁷  

Yog li ntawd, qhov kev rov tshwm sim thoob ntiaj teb tam sim no ntawm tus kab mob qhua pias yog qhov kev hu kom rov ua kom muaj zog rau kev txhaj tshuaj tiv thaiv kab mob thiab, tib lub sijhawm, kom txhawb nqa kev tshawb fawb txog kev kho mob hloov kho kab mob rau SSPE. Rau cov kws tshwj xeeb txog kev txav mus los, kev ceev faj yog qhov tseem ceeb, tsis yog rau kev paub thaum ntxov thiab kev tswj cov tsos mob xwb tab sis kuj rau kev pab txhawb rau kev tawm tswv yim ntawm ntau yam kev kawm rau kev tiv thaiv. 

Nyeem tsab xov xwm

Mloog kev xam phaj podcast txog tsab xov xwm no:   Mloog tam sim no

 

References 

1. CDC. Cov Neeg Mob Qhua Plab Thiab Kev Sib Kis Kab Mob. Qhua Plab (Rubeola). Kaum Ib Hlis 5, 2025. Nkag mus rau Kaum Ib Hlis 9, 2025. https://www.cdc.gov/measles/data-research/index.html 
2. Jafri SK, Kumar R, Ibrahim SH. Subacute sclerosing panencephalitis - kev xam pom tam sim no. Pediatric Health Med Ther. 2018;9:67-71. doi:10.2147/PHMT.S126293 
3. Dyken PR. Kab mob Subacute sclerosing panencephalitis. Xwm txheej tam sim no. Neurol Clin. 1985;3(1):179-196. 
4. Garg D, Sharma S. Kev Kho Mob Hloov Kho Kab Mob hauv Subacute Sclerosing Panencephalitis: Ib Thaj Chaw Tsaus Ntuj. Ann Indian Acad Neurol. 2023;26(1):3-9. doi:10.4103/aian.aian_655_22 
5. Garg D, Patel S, Sankhla CS, thiab lwm tus. Kev Txav Mus Los Hauv Cov Neeg Mob Uas Muaj Subacute Sclerosing Panencephalitis: Kev Tshuaj Xyuas Txhua Yam. Mov Disord Clin Pract. 2024;11(7):770-785. doi:10.1002/mdc3.14062 
6. Kab mob qhua pias. Nkag mus rau lub Kaum Ib Hlis 9, 2025. https://www.who.int/news-room/fact-sheets/detail/measles 
7. Cov tshuaj tiv thaiv kab mob qhua pias. Nkag mus rau lub Kaum Ib Hlis 9, 2025. https://www.who.int/groups/global-advisory-committee-on-vaccine-safety/topics/measles-vaccines 

 

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